Facial nerve dysfunction in osteopetrosis

When facial nerve dysfunction occurs in conjunction with one of the rare temporal bone dysplasias, the physician faces a therapeutic dilemma. There is no consensus in the literature regarding the management of facial paralysis or facial spasm under these circumstances. During the past 2 years, four patients were seen with forms of osteopetroses and neurotologic symptoms. A patient with malignant, recessive osteopetrosis and a patient with Engelmann's disease were surgically managed for facial paralysis and facial spasm. The outcome of the treatment is discussed as well as the available literature on this subject. A new complication of facial nerve decompression in children with osteopetrosis is described, as well as appropriate caveats in the management of facial nerve disorders in the osteopetroses.