Bell's Palsy: A Surgical Emergency?

Denervation in Bell’s Palsy

“…Jongkees [9] emphasized the need for emergency decompression. We com pared the recovery of facial movement attained after decompression with that attained after medical treatment in groups of patients whose denerva tions were of the same degree.…”

“…Based on accumulating clinical experiences, a considerable number of authors have presented the evidences that an administration of a corticosteroid hormon [19,21] or surgical decom pression of the facial nerve [2,[8][9][10]23] in the temporal bone prior to advancing denervation had favorable effect in preventing further progress of the axonal degeneration and facilitated earlier and better functional restoration of the facial nerve. Early detection of denervation is critical when these treatments are being considered, since good results are in versely related to the delay in the treatment.…”

Bell's palsy: prognostic accuracy of case history, sialometry and taste impairment

“…The values for the sialometry quotient (4) for resting and stimulated secretion for the four groups are displayed in Table 9.…”

“…Fourteen of the 26 patients (53.8%) in groups I and I1 with complete recovery reached or exceeded the lower tolerance limit for healthy individuals (q = 0.73) while none of the 1 2 patients in group I11 and IV did so. Figure z shows the number of patients in cumulative form versus the quotient values (4) using 6% citric acid as a stimulant. y = 0.45 is the lowest critical value of the salivary quotient that will yield the same number of false positive and false negative results if it were regarded as a criterion for complete or incomplete recovery.…”

Facial nerve palsy: five year survey

“…They had decompression and nerve graft but recovery was poor. Jongkees (5) demonstrated at time of surgery that the nerve is edematous and hyperemic during the first six to eight weeks. After eight week?…”