It is rare with blunt football injury but commonly seen with vehicular accidents. The fracture line across the facial nerve canal is excellently depicted in CT scan. Though, it is controversial, best out-come is anticipated with earlier transmastoid facial nerve decompression, in injury distal to geniculate ganglion.
The facial nerve is one of the key cranial nerves with a complex and broad range of functions. Although at first glance it is the motor nerve of facial expression which begins as a trunk and emerges from the parotid gland as five branches see facial nerve branches mnemonicit has taste and parasympathetic fibers that relay in a complex manner. The facial nerve is the only cranial nerve that may show normal post-contrast enhancement, although this applies only to the labyrinthine segment up to the stylomastoid foramen.
Throughout human evolution, traumas severe enough to fracture the temporal bone were probably not compatible with survival. However, with the advances of modern medicine people are more likely to survive these injuries. Therefore, familiarity with their diagnosis and management is important.
In this article, we shall look at the anatomical course of the nerve, and the motor, sensory and parasympathetic functions of its terminal branches. The course of the facial nerve is very complex. There are many branches, which transmit a combination of sensory, motor and parasympathetic fibres. The nerve arises in the ponsan area of the brainstem.
The middle ear consists of the tympanic cavity and the antrum. The antrum is a large aircell superior and posterior to the tympanic cavity and connected to the tympanic cavity via the aditus ad antrum. The epitympanum or attic is the upper portion of the tympanic cavity above the tympanic membrane, and contains the head of the malleus and the body of the incus.
The authors have no personal financial or institutional interest in any of the materials or devices described in this article. Eduard H. Voormolen, Marijn van Stralen, Peter A.
It emerges from the pons of the brainstemcontrols the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. It arises from the brainstem from an area posterior to the cranial nerve VI abducens nerve and anterior to cranial nerve VIII vestibulocochlear nerve. The facial nerve also supplies preganglionic parasympathetic fibers to several head and neck ganglia.
It emerges at the lower border of the pons above the olive. Three branches originate here:. The labyrinthine segment is the shortest only measuring mm.
Temporal bone fractures are not uncommon injuries in patients exposed to head trauma. They call for an early diagnosis, including a careful otoneurological examination and thin sections high resolution CT examination. A case of delayed diagnosis of temporal bone fracture with facial nerve paralysis is presented.