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Background and Objectives The aim of this study is to evaluate the outcomes and prognosis of traumatic facial paralysis in patients treated with facial nerve decompression via transmastoid approach. Subjects and Method The authors retrospectively reviewed 20 patients who suffered from temporal bone fractures resulting in facial paralysis and received surgical facial nerve decompression treatment via transmastoid approach from 2004 to 2012. Results In 14 patients, the House-Brackmann grade improved to 1, 2, or 3. The preoperative average House-Brackmann grade of 4.95 improved from 4.95 to the postoperative average House-Brackmann grade of 3.15. Statistically significant improvements were found in all groups whether the operation was performed within two weeks, or from two weeks to four weeks, or after four weeks. Conclusion Postoperative results of facial nerve decompression in traumatic temporal bone fracture can be excellent. Surgeons can expect better outcomes with early diagnosis and lesser nerve damage.

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