Delayed Onset Facial Palsy After Temporal Bone Fracture: A Case Series

Abstract

Study Design: Retrospective Case Series Objective: This study’s objective is to identify gaps in facial trauma care by exploring 4 cases of delayed onset facial nerve palsy after temporal bone fracture. Methods: A retrospective chart review was performed on 4 patients who presented to the emergency department with facial palsy after a previous trauma. Relevant physical exam findings, radiological images and follow-up was documented. Results: We present a case series of young, previously healthy patients who presented to the emergency department days or weeks after traumatic temporal bone fracture with delayed onset unilateral facial nerve paralysis. None of these patients were warned of this potential complication, connected to an outpatient physician and all received a costly workup. Conclusions: Patients presenting with temporal bone fracture and intact facial nerve function can develop delayed-onset facial paralysis several days after their injury. To offset costly and stressful return visits to the emergency department, patients with temporal bone fractures along the course of the facial nerve should receive education regarding the possible delayed development of facial palsy prior to discharge and otolaryngological or primary care follow-up within 2 weeks of the injury.