The Pathology and Surgical Treatment of Bell's Palsy

Surgery and Pathology of Bell's Palsy

“…7,8 In carrying out the decompression opera¬ tion on the facial nerve in patients suffer¬ ing from Bell's palsy, the bulging of the nerve on incising the sheath was confirmed (Fig 1 and 2), but we observed that this was not confined to the descending portion of the fallopian canal ; a similar result was also observed in the horizontal section. It was decided, therefore, in all patients in whom relief of pressure was desired, to also carry out decompression of the hori- Fig 4.-Exposure of the facial nerve through a retroauricular incision (photograph of cadaver specimen taken through an operating microscope) ; A, lateral semicircular canal ; B, decompressed vertical part of facial nerve; C, incus and stapes below which the exposed horizontal part of the facial nerve is visible.…”

Observations on Melkersson’s syndrome

“…As it descends the aqueduct it increases in thickness and strength which reaches a maximum in density and tough-ness as it approaches the stylomastoid foramen. When the Fallopian canal is explored for compression and the facial sheath slit, the nerve laterally herniates through the incision (Ballance & Duel, 1932;Morris, 1938;Cawthorne, 1951;Kettel, 1947;Sullivan & Smith, 1950), and is seen to be markedly congested and swollen to twice its normal size (Hall, 1951). This process is particularly marked in the lower third of the canal.…”

Do children with Bell's palsy benefit from steroid treatment? A systematic review

“…The cause of BP is still unclear. Whether associated with vascular ischemia, infection or inflammation, a subsequent mechanical compression of the facial nerve in the temporal bone may develop as was seen during decompression procedures in patients with BP [3][4][5]. Steroids may reduce the inflammatory process, neural edema and compression of the nerve in the facial canal [6,7].…”