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Facial nerve decompression for idiopathic Bell's palsy: report of 13 cases and literature review

Published online by Cambridge University Press:  02 October 2009

C Bodénez ,
I Bernat ,
J-C Willer ,
P Barré ,
G Lamas  and
F Tankéré
C Bodénez*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Pitié-Salpêtrière Hospital, Paris, France
I Bernat
Affiliation:
Department of Clinical Neurophysiology, Pitié-Salpêtrière Hospital, Paris, France
J-C Willer
Affiliation:
Department of Clinical Neurophysiology, Pitié-Salpêtrière Hospital, Paris, France
P Barré
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Pitié-Salpêtrière Hospital, Paris, France
G Lamas
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Pitié-Salpêtrière Hospital, Paris, France
F Tankéré
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Pitié-Salpêtrière Hospital, Paris, France
*
Address for correspondence: Dr Camille Bodénez, Department of Otolaryngology – Head and Neck Surgery, Pitié-Salpêtrière Hospital, 47–83 Bd de l'Hôpital, 75651 Paris Cédex 13, France. Fax: 331 42 16 31 05 E-mail: camille.bodenez@yahoo.fr
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Abstract

Introduction:

The prognosis for cases of idiopathic facial palsy is usually good. However, some cases develop disabling sequelae, such as synkinesis or severe facial hemispasm, despite targeted medical treatment.

Objectives:

The authors try to achieve that electromyography is useful to identify patients with severe palsy and an unfavourable prognosis. These patients would probably benefit from facial nerve decompression.

Setting:

The otolaryngology – head and neck surgery department of Pitié-Salpêtrière Hospital, Paris, a tertiary referral centre.

Participants:

Thirteen cases undergoing surgery between January 1997 and March 2007.

Main outcome measures:

We describe the electromyographic findings that led to surgery. All patients underwent surgery via a subpetrous approach, within four months of the onset of palsy. Decompression involved the first and second portions of the nerve and the geniculate ganglion.

Results:

Recovery to House–Brackmann grade III was obtained in all cases at one year follow up.

Conclusion:

These results compared favourably with previous reports. A new therapeutic procedure may allow improved results.

Keywords

Facial ParalysisOtologic Surgical ProceduresBell's Palsy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 3 , March 2010 , pp. 272 - 278
Copyright
Copyright © JLO (1984) Limited 2009

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