A New Surgical Option For Patients with Unresolved Bell's Palsy

Curr Neurol Neurosci Rep. 2024 Sep;24(9):381-387. doi: 10.1007/s11910-024-01358-7. Epub 2024 Jul 24.

Abstract

Purpose: This paper describes a new surgical procedure with electrical stimulation of the facial nerve for unresolved Bell's palsy and compares the facial nerve recovery with another group who underwent traditional middle cranial fossa decompression.

Recent findings: All patients with total unilateral facial paralysis had surgery by the senior author 3 months from onset of Bell's Palsy. Surgical decompression was performed in 13 patients between 1992-2012 (Group 1). Surgical exposure with intraoperative electrical stimulation of the facial nerve in the peri-geniculate region was performed in 47 patients between 2012-2022 (Group 2). The facial recovery at 1 month and 3 month were significantly better in Group 2. The degree of synkinesis was significantly less in Group 2. The trans-mastoid electrical stimulation of the facial nerve is less invasive, requires no hospital stay, and less time off work compared to the middle cranial fossa approach. The earlier facial movement at one month results in less long-term unwanted faulty regeneration or synkinesis.

Keywords: Bell’s Palsy; Facial Nerve Electrical Stimulation; Facial Paralysis; Facial Synkinesis; Geniculate Ganglion.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Bell Palsy* / physiopathology
  • Bell Palsy* / surgery
  • Decompression, Surgical / methods
  • Facial Nerve* / physiopathology
  • Facial Nerve* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Recovery of Function
  • Treatment Outcome
  • Young Adult