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


OBJECTIVE
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.


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


METHODS
Thirteen cases undergoing surgery between January 1997 and March 2007.


METHODS
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.


CONCLUSIONS
These results compared favourably with previous reports. A new therapeutic procedure may allow improved results.
Bodénez
C
C
Department of Otolaryngology-Head and Neck Surgery, Pitié-Salpêtrière Hospital, Paris, France. camille.bodenez@yahoo.fr
Bernat
I
I
Willer
J-C
JC
Barré
P
P
Lamas
G
G
Tankéré
F
F
D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D007758:Ear, Inner / Q000293:injuries; D004487:Edema / Q000503:physiopathology; D004576:Electromyography; D005154:Facial Nerve / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000175:diagnosis; D009416:Nerve Regeneration / Q000502:physiology; D010579:Petrous Bone / Q000601:surgery; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult