Transmastoid decompression as a treatment of Bell palsy

• Published in: Otolaryngology-head and neck surgery Vol. 124; no. 3; p. 282
• Main Authors: Yanagihara, N, Hato, N, Murakami, S, Honda, N
• Format: Journal Article
• Language: English
• Published: England 01.03.2001
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents - therapeutic use; Bell Palsy - drug therapy; Bell Palsy - physiopathology; Bell Palsy - surgery; Decompression, Surgical; Electromyography; Facial Nerve - physiopathology; Female; Humans; Male; Mastoid - surgery; Middle Aged; Otologic Surgical Procedures; Prednisone - therapeutic use; Severity of Illness Index; Treatment Outcome
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1067/mhn.2001.112309

We sought to assess the efficacy of transmastoid decompression after steroid treatment. One hundred one adults with Bell palsy having denervation exceeding 95% after steroid treatment were divided into 2 groups. In 58 patients decompression from the labyrinthine segment to the stylomastoid foramen was performed, and the remaining 43 patients were only followed up. Using the Yanagihara score and House Brackmann grading system, the recovery from the palsy was assessed. There was a statistically significant difference in the final facial score of the 2 groups. Within 60 days after the onset, the chance of better recovery from the palsy was higher in the patients with decompression. In the era of steroid treatment, we cannot discard the transmastoid decompression of the facial nerve in the treatment of severe Bell palsy with profound denervation, although further effort is needed to obtain definitive evidence to show the benefit of the operation.