Surgical Management of Bell’s Palsy

Kartum T. A., Küçükyürük B., Sanus G. Z.

in: SURGICAL MANAGEMENT OF FACIAL NERVE PARALYSIS, Prof. Dr. Galip Zihni Sanus,Assoc. Prof. Dr. Ayşegül Batioglu Karaaltın, Editor, Türkiye Klinikleri Yayınevi, Ankara, pp.82-85, 2022

  • Publication Type: Book Chapter / Chapter Vocational Book
  • Publication Date: 2022
  • Publisher: Türkiye Klinikleri Yayınevi
  • City: Ankara
  • Page Numbers: pp.82-85
  • Editors: Prof. Dr. Galip Zihni Sanus,Assoc. Prof. Dr. Ayşegül Batioglu Karaaltın, Editor
  • Istanbul University-Cerrahpasa Affiliated: Yes

Abstract

Bell’s palsy composes 75% of all acute facial paralysis cases. Conservative treatment is usually sufficient to restore facial nerve function in patients with Bell’s palsy, but surgical decompression may be necessary in a group of patients who do not benefit from conservative treatment. For determining the indication of surgery, most accurate and reliable electrophysiological tests currently in use are electroneurography (ENoG) and electromyography (EMG). Electrophysiological testing promotes to identify patients who are at risk for poor recovery with conservative treatment alone and these patients may be candidate for surgery. Intraoperative studies of the facial nerve showed that the conduction block is proximal to the geniculate ganglion (GG) and within the internal acoustic canal (IAC). The middle cranial fossa (MCF) approach provides access to segments of the facial nerve from the cisternal segment to the proximal tympanic segment without disrupting hearing and vestibular functions.