Damage to the seventh cranial nerve prior to or during delivery can result in which outcome?

• A. Vocal cord paralysis
• B. Torticollis
• C. Paralysis of the affected side of the face
• D. Hearing loss

Answer: (C)

The seventh cranial nerve is the facial nerve, which controls the muscles of facial expression. When it is injured during birth, it causes unilateral facial paralysis on the side of the injury. This presents as drooping of the mouth, inability to close the eye on that side, and a flattened nasolabial crease, with the face looking asymmetrical. Most perinatal facial nerve palsies improve as the nerve heals over days to weeks.

Vocal cord paralysis would involve the vagus nerve affecting laryngeal muscles, not the facial nerve. Torticollis is typically due to neck muscle or other musculoskeletal issues, not direct facial nerve injury. Hearing loss involves the auditory pathway (vestibulocochlear nerve or auditory structures), not the facial nerve.