Abstract

Introduction

Face is the interpreter of emotions, mirror of soul, powerhouse of senses and way for communication.

Facial nerve is the seventh cranial nerve which serves vital functions of lacrimation, salivation, taste, hearing and facial expression. It necessitates urgent measures to understand the cause and nature of nerve injury and undertake immediate steps for restoration and rehabilitation of facial symmetry. About 90% of lower motor neuron facial nerve disorders- inflammatory, traumatic or neoplastic, happens along its intratemporal course.

Over past two decades, many developments have been made. Newer technologies like radiology, electrodiagnostic study and emergence of intraoperative monitoring have been helpful. Complex course within the bony canal, congenital dehiscence, fine branching, interconnections, segmental blood supply, all these factors show significantly, heading towards causation and final result of insult to nerve. A list of etiologies commonly Bell's palsy, followed by Temporal bone fracture, Iatrogenic trauma, Herpes Zoster Oticus, Otitis Media (OM), Cerebellopontine (CP) angle or Intratemporal neoplasm (facial nerve Schwannoma), result in facial nerve paralysis.

The nerve testing depends on determining the scale of distal axonal degeneration (electrodiagnosis), function of branches of the nerve (topo diagnosis) and radiologic guidance in indicated cases1. The pathways of the facial nerve are variable, and knowledge of the key intratemporal and extratemporal landmarks is essential for accurate physical diagnosis and safe and effective surgical intervention.