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Forceps-Related Nerve Palsy Usually Appears Mild And Transient In Neonates

According to the study findings, the facial nerve palsy that can arise in neonates from forceps use at birth is usually mild and nearly always resolves spontaneously.

Facial nerve palsy, seen in 8.8 cases per 1000 forceps-delivered births, is induced by the pressure of the posterior blade of the forceps or the maternal sacral promontory onto the stylomastoid foramen, or by compression of the bone overlying the vertical segment of the facial canal, study co-authors Drs. Melanie Duval and Sam J. Daniel explain.

Although the complication was discovered 150 years ago with unclear outcomes. Dr. Duval, from McGill University, Montreal, and Dr. Daniel, from Montreal Children’s Hospital, investigated data from all cases of forceps-related facial nerve palsy that arose at two tertiary care centers from April 1, 1989 to April 1, 2005.

The study identified 28 cases of facial nerve palsy secondary to forceps use. Most of the cases identified were mild to moderate in severity.

Except one infant who received a brief course of steroids, none of the patients were treated for their nerve palsy. Of all, 21 infants had adequate data for long-term follow-up and in all of these cases, a full recovery occurred. The average time was 24 days for complete recovery.

The facial nerve palsy may cause considerable parental distress. However, the current findings indicate that all or virtually all infants experience a full recovery and there is probably no need for treatment.