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Bell's palsy: Surgery based upon prognostic indicators and results
Author(s) -
May Mark,
Blumenthal Frank,
Taylor Floyd H.
Publication year - 1981
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198112000-00011
Subject(s) - bell's palsy , medicine , palsy , facial nerve , decompression , electromyography , facial paralysis , surgery , electroneuronography , physical medicine and rehabilitation , alternative medicine , pathology
We studied 164 patients with Bell's palsy prospectively over the six‐year period between August 1974 and June 1980. We found that the results of measuring tear production, sub‐mandibular salivary flow, the response to maximal stimulation, and evoked electromyography gave us sufficient information to group these patients according to prognosis —either unfavorable or favorable — for spontaneous return of facial function. When the test results were 26% or more of normal, 90% of the patients had complete recovery of function; these patients were given a favorable prognosis on the basis of the results of tests described above. The natural history of Bell's palsy in patients with an unfavorable prognosis could be improved if a transmastoid facial nerve decompression to the labyrinthine segment were performed. The results were better with this approach than with supportive or steroid therapy or transmastoid vertical‐horizontal surgical decompression of the facial nerve.