To study the main prognostic factors and significance of facial nerve decompression of facial paralysis in temporal bone fracture, the main relative prognostic factors of 64 patients with facial paralysis were analyzed. Experimental model of facial paralysis was made. Expansion rate of facial nerve in facial canal opening group and non-opening group was measured and observed under electron microscope. The main factors affecting the prognosis were facial nerve decompression and selection of surgery time. Expansion rate of facial nerve in opening group was significantly higher than that of non-opening group. Injury degree of nerve fiber of non-opening group was severe. It is suggested that early facial nerve decompression is of beneficial to restoration of facial nerve function.