Peripheral facial nerve dysfunction: CT evaluation.

Abstract

Peripheral facial nerve dysfunction may have a clinically apparent or occult cause. The clinical and radiographic records of 36 patients with peripheral facial nerve dysfunction to obtain information on the location of the suspected lesion and the number, sequence and type of radiographic evaluations performed. Inadequate clinical evaluations before computed tomography (CT) was done and unnecessary CT examinations were also noted. In those patients in whom the cause of peripheral facial nerve dysfunction is apparent, the clinical-radiographic workup is self-evident. When the cause of dysfunction is occult, however, a tailored CT examination should be done based on a thorough clinical evaluation. A practical clinical and radiographic scheme to evaluate progressive peripheral facial dysfunction with no apparent cause is suggested. [At the time of radiographic evaluation, 20 of the 36 patients had clinically occult lesoins. Six (33%) of these 20 patients had significant delays in diagnosis of the lesion affecting the facial nerve. Five of the 6 patients were proved to have malignant tumors.] If this scheme is applied, unnecessary radiologic tests and delays in diagnosis and treatment may be avoided.