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

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.