MANAGEMENT OF TRAUMATIC FACIAL-NERVE PARALYSIS WITH CAROTID-ARTERY CAVERNOUS SINUS FISTULA

Massive skull base injuries require detailed preoperative neurological and neurovascular assessment prior to undertaking surgical repair of isolated cranial nerve deficits. We present the management of a patien t with traumatic facial paralysis, cerebrospinal fluid leak, and carot id artery cavernous sinus fistula as the result of a gunshot wound to the skull base. The carotid artery cavernous sinus fistula was ultimat ely controlled with superselective embolization via the vertebral arte ry. The facial nerve injury was then safely treated with mobilization of the labyrinthine and vertical segments to allow a primary anastomos is.