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Scientific Oral Presentations (Best of Scientific Oral)

Facial Plastic and Reconstructive Surgery

Session: Best of Scientific Oral Presentations 1

ENoG Correlation With Facial Paralysis Outcomes in Temporal Bone Fracture

Saturday, September 28, 2024
1:18 PM – 1:24 PM EDT
Location: MBCC, 222
Disclosure(s):
Heather D. Merkouris, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Aaron E. Bunnell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Gavriel D. Kohlberg, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

G. Nina N. Lu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: While electroneuronography (ENoG) has been established as a prognostic for patients with facial palsy due to Bell’s palsy and Ramsay-Hunt syndrome, its predictive capacity for facial nerve outcomes in patients with facial palsy due to temporal bone fractures is unclear. In this study, we examine the association between ENoG and facial nerve recovery in patients with temporal bone fracture.

Methods: Retrospective review of electronic medical records from facial paralysis patients with ipsilateral temporal bone fracture and ENoG between 2012 – 2023. Patient data recorded included demographic and clinical information, ENoG scores, and facial nerve outcomes. HB 1/2 was considered good recovery, HB 3/4 was considered partial recovery, and HB 5/6 was considered poor recovery.

Results: A total of 24 patients met inclusion criteria. 12/24 patients had good recovery, 9/24 patients had partial recovery, and 3/24 patients had poor recovery. ENoG % ranged from 0-73.7% for those with good recovery, 0-16.7% for those with partial recovery, and 0-18.7% for those with poor recovery. ENoG correlation to final HB score was 0.46. All patients with initial ENoG >20% had good recovery of facial nerve function. For ENoG scores < 20%, recovery ranged widely. All patients with a delayed onset of facial paralysis (10/24) recovered to at least a HB 3. Three patients had poor recovery; two with immediate onset paralysis and one was unknown. All patients with good recovery had onset of recovery noted within 6 months of paralysis. Three patients underwent facial nerve decompression; two underwent transmastoid approach and recovered to HB 2 and 5, one patient underwent transcanal endoscopic facial nerve decompression and recovered to HB 3.

Conclusions: Patients with delayed onset of facial paralysis after temporal bone trauma recovered to at least HB 3 regardless of ENoG score. ENoG >20% was predictive of good facial nerve recovery while ENoG scores < 20% were unpredictive of ultimate facial nerve outcome. Multiple factors in addition to ENoG scores are likely necessary to help predict poor facial nerve recovery in this patient population.

    Presenting Author(s)

  • Heather D. Merkouris, MS

    Medical Student
    University of Washington School of Medicine
    Seattle, WA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • AB

    Aaron E. Bunnell, MD

    Associate professor
    Department of Physical Medical and Rehabilitation - University of Washington School of Medicine
    North Bend, WA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JR

    Jay T. Rubinstein, MD, PhD

    Virginia Merrill Bloedel Professor and Director
    University of Washington
    Seattle, WA, United States

    Disclosure information not submitted.

  • Gavriel D. Kohlberg, MD

    Assistant professor
    Department of Otolaryngology - Head and Neck Surgery, University of Washington
    Seattle, WA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • G. Nina N. Lu, MD

    Assistant Professor
    UNIVERSITY OF WASHINGTON
    SEATTLE, WA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.