Trauma Mon. 2015 November; 20(4): e20578. doi: 10.5812/traumamon.20578 Published online 2015 November 23. Case Report Recovery of Facial Nerve Paralysis After Temporal Nerve Reconstruction: A Case Report Mohammad Reza Emamhadi 1 and Davood Mahmoudi 1,* 1 Brachial Plexus and Peripheral Nerve Injury Center, Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, IR Iran *Corresponding author: Davood Mahmoudi, Brachial Plexus and Peripheral Nerve Injury Center, Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-9121399790, Fax: +98-1333331472, E-mail: drdmahmoudi@yahoo.com Received 2014 May 28; Revised 2014 August 7; Accepted 2014 August 16. Abstract Introduction: Facial paralysis is common following accidents, trauma, viral infection or tumors. Case Presentation: A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right forehead. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomosis of branches of the temporal nerve was done one month after trauma following regular physical therapy sessions, outcome was good and paralysis of the muscles of the right forehead improved after several months. Conclusions: Immediate repair of the facial nerve injury will improve the process of recovery and rehabilitation of the face and forehead muscles and may play a very important role in the patient’s mental satisfaction and improve their quality of life. Keywords: Facial Nerve Paralysis, Temporal Nerve Reconstruction, Temporal Penetrating Trauma Copyright © 2015, Trauma Monthly. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 Inter- national License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited. 1. Introduction 1.1. Facial Nerve Paralysis Facial paralysis is common following accidents, trauma, virus infection or tumors. Facial paralysis will affect the patient psychologically, and may cause depression and anxiety. In this report, we present a case of a young man with unilateral paralysis of the muscles of the forehead caused by penetrating trauma who recovered after repair of the temporal branch of the facial nerve. Nerve repair was done one month after trauma and recovery was good 3 months later. 1.2. Facial Nerve The facial nerve, cranial nerve VII, is a complex periph- eral nerve (motor-sensory-secretory) which has a large motor branch and a smaller sensory one. The nerve is damaged more than the other cranial nerves. The pathways of the facial nerve are variable and run from the skull base to the face. This nerve passes inside the tem- poral bone and through the internal auditory canal beside the vestibulocochlear nerve. In the extracranial part of the pathway in the parotid gland, the facial nerve divides into 5 branches that innervate 14 of the 17 paired muscle groups of the face. The distal portion of the facial nerve include the cervical branch, mandibular branch, buccal branch, zygomatic branches, temporal branches and pos- terior auricular branch. 1.3. Temporal Nerve (Frontal Nerve) The temporal branch of the facial nerve (frontal branch of the facial nerve) crosses the zygomatic arch in the temporal region, supplying the auriculares anterior and superior. The more anterior branches supply the frontalis, the orbicularis oculi, and corrugator supercilii and muscles. To test the function of the temporal branches of the facial nerve, the patient is asked to frown and wrinkle his or her forehead. 2. Case Presentation A 24-year-old male patient was referred to us with a history of sharp penetrating trauma to the right temporal region causing unilateral paralysis of the muscles of the right fore- head. He was unable to scowl or elevate his right eyebrow and there were no folds on his right forehead. Anastomo- sis of branches of the temporal nerve was done one month after trauma following regular physical therapy sessions, outcome was good and paralysis of the muscles of the right forehead improved after several months (Figure 1). 2.1. Management and Results The right frontalis, orbicularis oculi and corrugator su- percilii muscles were paralyzed. Electromyography was done 3 weeks after trauma and complete severance of the temporal nerve branch of the facial nerve was reported. The temporal nerve repair was done one month after trauma.