Transmastoid Decompression of the Facial Nerve in Bell's Palsy

Facial nerve decompression for idiopathic Bell's palsy: report of 13 cases and literature review

“…Frank oedema with herniation of the nerve fibres is frequently observed on opening the nerve sheath, 2 , 8 , 11 , 28 , 29 , 33 , 34 as was the case in all our patients. In our opinion, surgical intervention eliminates nerve compression, particularly in the meatal foramen segment, and above all favours axonal regrowth by reducing ischaemia.…”

“…This latter fact could, in part, explain the study results, in view of the importance granted to this site by other anatomical and clinical studies 8 – 12 , 38 . Nevertheless, Yanagihara et al , 24 , 28 using the same procedure, reported that 85 per cent of patients operated upon in the first month of onset achieved House–Brackmann grades of I and II. The chances of obtaining good quality recovery would be reduced by 23 per cent in the absence of surgical treatment and results are markedly more mediocre when decompression is undertaken after one month 24, 28 .…”

“…Nevertheless, Yanagihara et al , 24 , 28 using the same procedure, reported that 85 per cent of patients operated upon in the first month of onset achieved House–Brackmann grades of I and II. The chances of obtaining good quality recovery would be reduced by 23 per cent in the absence of surgical treatment and results are markedly more mediocre when decompression is undertaken after one month 24, 28 . Fisch, 12 in a series of 25 patients, showed the benefits of surgery via the subpetrous approach, compared with medical treatment alone, in patients with more than 95 per cent degeneration seen on electroneurography performed within the first two weeks of palsy onset: of those receiving medical treatment, 64 per cent achieved good quality facial recovery, compared with 78.8 per cent for those receiving surgical treatment.…”

Differences in the Diameter of Facial Nerve and Facial Canal in Bell’s Palsy—A 3-Dimensional Temporal Bone Study

“…These findings, in conjunction with the observation of canal diameter differences between the groups in the tympanic and mastoid segments alone (and not labyrinthine) could corroborate the clinical improvement of patients with Bell's palsy that undergo the transmastoid surgery for facial nerve decompression (13–15). …”

Endoscopic trans‐canal facial nerve decompression in Melkersson–Rosenthal syndrome: A novel approach

“…This surgical procedure was proposed by Yanagihara et al. 7 provisionally the incus is removed and then repositioned entirely to expose the labyrinthine section and geniculate ganglion. This method is considerable for preventing damage to the stapes and the inner ear, but there is still a risk of mild conductive hearing loss.…”