Meta-analysis Of The Best Timing For Surgical Treatment Of Traumatic Facial Paralysis

Objective:The method of meta-analysis was used to systematicallyevaluatetheinfluenceoffacialnerve decompression on the prognosis of traumatic facial paralysis.The evidence-based medical basis for the choice of timing of traumatic facial paralysis was used to guide the treatment of traumatic facial paralysis.Methods:The PubMed,Embase,and Cochrane clinical trial databases were searched for by"Traumatic facial paralysis","Surgical timing","Facial nerve decompression"and"Temporal bone fracture"."traumatic facial paralysis","tibia fracture","facial nerve decompression"and"surgical timing"were used as Chinese search terms,and the Chinese Journal Network full-text database,Weipu and Wanfang database were searched.The time of publication of the literaturewasupdatedtoDecember~2018.Two researchers independentlyscreenedtheliteratureandincluded retrospective and prospective studies on the treatment of traumatic facial paralysis by different surgical timings in different databases.The study carried out data extraction.Statistical analysis using stata12.0 software.Results:A total of 127 relevant literatures were detected,and 9literatures that met the criteria were finally included.Among them,the course of the cure was the most in the course of the disease in<1 month,1-2 months,and 2-3 months.The operation timing in March has a good clinical cure rate,in which the timing of surgery is the best in 1 month,and the clinical cure rate is significantly reduced after 3 months.The timing of surgery<1 month and the timing of surgery>1 month is 95%.CI is(0.01-0.18),indicating that the timing of surgery in 1month is better than that>1 month,and the timing of surgery is 95%CI(1.38,1.76)in 1-2months>2-3 months.The timing of surgery in 1-2 months was better than>2-3 months.The timing of the operation was 95%CI(0.14-0.90)in the comparison of2-3 months and>3-6 months,indicating that the timing of surgery in 2-3 months was better than that in 3-6 months,and the timing of surgery was from 3-6 months>6 months comparison of 95%CI is(1.14-11.09),indicating that the timing of surgery from 3-6 months is better than>6 months.As can be seen from the sequencing diagram,surgery in January is the most effective,with the SUCRA value of 97.3%,followed by that in January and February,with the SUCRA value of75.6%.Conclusion:As for the choice of surgical timing for traumatic facial paralysis,all surgeries performed within 3months were effective,the effect of preoperative course<1month was the best,and the effect of preoperative course was also better in 1-2 months.The clinical cure rate decreased significantly after 3 months,and the longer the time interval between trauma and surgery,the worse the prognosis.