Trauma

Question 1

Management of penetrating facial trauma causing facial nerve injury

Answer 1

• Injury is medial to the lateral canthus of the eye = Non-operative management as nerve can arborize
• Injury is lateral to the lateral canthus of the eye = surgical exploration
• If facial nerve paralysis is present, exploration must be done within 72 hours
• If nerve is transected, epineural layers should be approximated in tension-free repair. Otherwise, an interposition grfta may be necessary