Traumatic Facial Nerve Palsy in Newborns: Is It Always Iatrogenic?

ABSTRACT

We sought to report an updated incidence, risk factors, and outcome of traumatic facial palsy (TFP) in newborn infants born at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. We performed a 12-year retrospective study at KAMC. The records of infants with the diagnosis of TFP during the study period were reviewed and compared with 148 healthy term infants born during the same study period. Among 83,067 infants delivered between January 1994 and December 2005, 29 infants were diagnosed with TFP for an incidence of 0.03%. Forceps delivery and maternal primiparity were the only significant risk factors for TFP. Only 7 (24.1%) of these infants were delivered by cesarean section. The other 22 cases of TFP (75.9%) were delivered without any forceps application. Almost all infants (93%) with TFP had spontaneous recovery within 2 months. Only one child suffered from permanent facial weakness when he was last examined at the age of 12 years. Although forceps delivery was considered the most significant risk factor, currently most of the cases occur spontaneously without forceps application. The majority of infants with TFP will recover spontaneously within the first 2 months of life.

Facial paralysis - forceps delivery - birth trauma - continuous positive airway pressure

REFERENCES

• 1 Sapin S O, Miller A A, Bass H N. Neonatal asymmetric crying facies: a new look at an old problem.  Clin Pediatr (Phila). 2005;  44 109-119
• 2 Smith J D, Crumley R L, Harker L A. Facial paralysis in the newborn.  Otolaryngol Head Neck Surg. 1981;  89 1021-1024
• 3 Falco N A, Eriksson E. Facial nerve palsy in the newborn: incidence and outcome.  Plast Reconstr Surg. 1990;  85 1-4
• 4 Maffei G, Magaldi L, Cassano P, Cassano M, Cella A, Magaldi R. Reversible facial nerve palsy secondary to nasal continuous positive airway pressure.  J Perinat Med. 2008;  36 550-551
• 5 Yetiser S. Non-traumatic congenital facial nerve paralysis; electroneurophysiologic evaluation of four cases.  Int J Pediatr Otorhinolaryngol. 2005;  69 1419-1427
• 6 Camus M, Lefebvre G, Darbois Y. Paralysies faciales d'origine obstetricale: circonstances de survenue, evolution.  Rev Fr Gynecol Obstet. 1986;  81 145-147
• 7 Levine M G, Holroyde J, Woods Jr J R, Siddiqi T A, Scott M, Miodovnik M. Birth trauma: incidence and predisposing factors.  Obstet Gynecol. 1984;  63 792-795
• 8 Yalaburgi S B. Transient facial nerve palsy in neonates.  Cent Afr J Med. 1980;  26 256-257
• 9 Muler H, Cotin G, Ray J. Paralysis faciales obstetricales durables: forms cliniques.  Traitment Ann Otoloryngol Chir Cervicofac. 1970;  87 531-536
• 10 Kumari S, Bhargava S K, Choudhury P, Ghosh S. Facial palsy in newborn: clinical profile and long-term follow-up.  Indian Pediatr. 1980;  17 917-922
• 11 Duval M, Daniel S J. Facial nerve palsy in neonates secondary to forceps use.  Arch Otolaryngol Head Neck Surg. 2009;  135 634-636