FREQUENCY OF FACIAL NERVE PALSY IN BASE OF SKULL FRACTURES

MS KHAN; S SHARAFAT

doi:10.54112/pjicm.v5i02.161

Authors

MS KHAN Department of Neurosurgery Lady Reading Hospital Peshawar, Pakistan
S SHARAFAT Department of Neurosurgery Lady Reading Hospital Peshawar, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.161

Keywords:

Facial Nerve Palsy (FNP), Skull Base Fractures, House-Brackmann Scale, Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Road Traffic Accidents, Traumatic Brain Injury

Abstract

Background: Early recognition through standardized clinical and radiological evaluation is essential for timely management. Objective: To establish the frequency and clinical-radiological characteristics of FNP among patients presenting with skull base fractures, using a standardized diagnostic protocol. Study Design: Cross-sectional study. Setting: Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: 29-December-2024 to 29-May-2025. Methods: Adult patients (18–65 years) with CT-confirmed skull base fractures were consecutively enrolled. Patients with Glasgow Coma Scale (GCS) <8 or penetrating craniocerebral injuries were excluded. FNP was defined by acute unilateral facial weakness plus associated symptoms, supported by MRI evidence of neural injury. Clinical grading was performed using the House-Brackmann scale. Data were analyzed using SPSS version 26. Results: Out of 165 screened patients, 143 met the inclusion criteria. The mean age was 36.8 ± 12.5 years, with a male predominance (79.0%). Road traffic accidents were the most common cause (66.4%). The overall frequency of FNP was 7.0% (10/143; 95% CI: 3.4–12.5%). Of these, 70% presented with an acute onset, and 30% with a delayed onset. At presentation, 60% had complete paralysis (House-Brackmann Grade VI) and 40% had incomplete paralysis. MRI confirmed nerve injury in all cases, while CT demonstrated bony impingement in only one patient. Conclusion: The frequency of FNP in skull base fracture patients was 7.0%, most commonly presenting as acute, complete paralysis. MRI showed superior diagnostic yield over CT in confirming neural injury, highlighting its vital role in the evaluation and management of skull base trauma.

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