Transtympanic Stimulation of the Facial Nerve to Assess Nerve Integrity in Iatrogenic Facial Nerve Paralysis

Abstract

Facial nerve paralysis is a well-described complication of head and neck surgical procedures. When the nerve is purposefully transected, the clinical approach is often clear, involving nerve repair, grafting, or substitution. In cases where the extent of facial nerve injury is not obvious, the potential for recovery is often uncertain. 1 We present a case of complete ipsilateral facial paralysis after resection of a parapharyngeal space tumor in a child. We used transtympanic stimulation of the tympanic segment of the facial nerve to assess anatomic integrity of the nerve. More experience with this technique may provide valuable information in guiding the management of postoperative facial nerve injury.