POINT OF FACIAL NERVE VULNERABILITY DURING MASTOIDECTOMY AMONG INDIAN PATIENTS: A CROSS-SECTIONAL STUDY.

Rajarshi  Datta; Sayantani  Majumdar; Arpita  Sarkar; Satabdi  Sarkar

doi:10.51168/sjhrafrica.v5i3.1039

Authors

Rajarshi Datta Assistant Professor, Department of Anatomy, Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata, West Bengal, India.
Sayantani Majumdar Associate Professor, Department of Anatomy, Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata, West Bengal, India.
Arpita Sarkar Assistant Professor, Department of Anatomy, Jagannath Gupta Institute of Medical Sciences and Hospital, Kolkata, West Bengal, India.
Satabdi Sarkar Associate Professor, Department of Anatomy, AIIMS, Kalyani, West Bengal, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v5i3.1039

Keywords:

Mastoidectomy, Facial Nerve Injury, Second Genu, Indian Population

Abstract

Background

The petrous part of the temporal bone houses the major part of the intracranial courses of the facial nerve. The nerve might be injured during surgery involving the mastoid and tympanic region. The damage may cause facial asymmetry and impairment of facial muscle function. It may ruin a patient's face, affecting their mental and social health. This research seeks to identify the anatomical site most susceptible to facial nerve injury during surgical treatment of the mastoid and tympanic cavity.

Methods

A cross-sectional study of 198 mastoidectomies conducted by 10 surgeons was done. The number of mastoidectomies by each surgeon, the location of the injury, the grade of the nerve injury, and the number of recoveries were recorded. Statistical analysis was performed on the data obtained.

Results

Nine facial nerve injuries were reported among the 198 cases analyzed. The second genu was the most vulnerable site of nerve injury in our study. A Grade 3 injury was mostly found in the case of mastoidectomies. More than 70% of the cases recovered from the ‘facial nerve’ injury.

Conclusion

Injury of the nerve during mastoidectomy is the major complication faced by an otolaryngologist. Also, the injury paralyzes the facial muscles, having a significant impact on the patient’s life. The injury can be best avoided by a thorough study of the anatomy of the nerve. In our study, it is found that the second genu is the prominent site of the injury. The otolaryngologist should be careful while performing the mastoidectomies and monitor the facial nerve simultaneously.

Recommendations

Future research should focus on developing targeted surgical training and incorporating intraoperative nerve monitoring to reduce facial nerve injuries during mastoidectomies, thereby improving patient outcomes.