title: Facial nerve decompression surgery using bFGF-impregnated biodegradable gelatin hydrogel in patients with Bell palsy.
abstract: OBJECTIVE
  Basic fibroblast growth factor (bFGF) promotes the regeneration of denervated nerves. The aim of this study was to evaluate the regeneration-facilitating effects of novel facial nerve decompression surgery using bFGF in a gelatin hydrogel in patients with severe Bell palsy.
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Twenty patients with Bell palsy after more than 2 weeks following the onset of severe paralysis were treated with the new procedure. The facial nerve was decompressed between tympanic and mastoid segments via the mastoid. A bFGF-impregnated biodegradable gelatin hydrogel was placed around the exposed nerve. Regeneration of the facial nerve was evaluated by the House-Brackmann (H-B) grading system. The outcomes were compared with the authors' previous study, which reported outcomes of the patients who underwent conventional decompression surgery (n = 58) or conservative treatment (n = 43).
  
  
  RESULTS
  The complete recovery (H-B grade 1) rate of the novel surgery (75.0%) was significantly better than the rate of conventional surgery (44.8%) and conservative treatment (23.3%). Every patient in the novel decompression surgery group improved to H-B grade 2 or better even when undergone between 31 and 99 days after onset.
  
  
  CONCLUSIONS
  Advantages of this decompression surgery are low risk of complications and long effective period after onset of the paralysis. To the authors' knowledge, this is the first clinical report of the efficacy of bFGF using a new drug delivery system in patients with severe Bell palsy.
authors.affiliation: Department of Otolaryngology, Ehime University School of Medicine, Ehime, Japan. nhato@m.ehime-u.ac.jp
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.forename: Jumpei
authors.initials: J
authors.lastname: Nota
authors.forename: Hayato
authors.initials: H
authors.lastname: Komobuchi
authors.forename: Masato
authors.initials: M
authors.lastname: Teraoka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Gyo
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yanagihara
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tabata
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D020330:Bell Palsy / Q000601:surgery*; D019299:Decompression, Surgical; D005154:Facial Nerve / Q000601:surgery*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000494:pharmacology*; D005780:Gelatin; D006801:Humans; D020100:Hydrogels; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D020100:Hydrogels; D016222:Fibroblast Growth Factor 2; D005780:Gelatin