Facial Diplegia Secondary to Cranio-Maxillo-Facial Trauma: About a Case in the Cocody Teaching Hospital

Introduction: Facial diplegia refers to bilateral peripheral facial paralysis. It is a rare complication of craniomaxillofacial trauma that poses a diagnostic and therapeutic challenge. The purpose of this article is to highlight the diagnostic and therapeutic challenges in our practice. Observation: A 29-year-old patient, with no particular pathological history, was admitted to the department on 12/22/2023 for maxillofacial trauma with initial loss of consciousness following a road traffic accident. Clinical and radiological investigations revealed bilateral extra-labyrinthine fractures of the petrous bones associated with a Lefort II fracture, an intermaxillary disjunction, a fracture of the mandibular symphysis and frontal pneumencephaly. He underwent maxillofacial osteosynthesis on 02/01/2024. However, neurosurgical abstention was prescribed. Pneumo23 and anti-meningococcal vaccines were administered. The evolution was marked, on postoperative day 14, by simultaneous facial diplegia classified HB5 on the left and HB6 on the right according to the House and Brackmann classification. He was put on corticosteroid therapy and physiotherapy. After 3 months, there was a regression of facial paralysis on the left but persistence on the right still at HB5. Discussion: Facial diplegia is a rare complication of cranio-maxillo-facial trauma. Its diagnosis is difficult in our practice and its treatment, which is not consensual, remains a challenge.