Surgical Management of Bell’s Palsy

norosirurjiozel12-1-22kapak

Tufan Agah KARTUMa, Barış KÜÇÜKYÜRÜKa, Galip Zihni SANUSa
aİstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Neurosurgery, İstanbul, Türkiye

Kartum TA, Küçükyürük B, Sanus GZ. Surgical management of Bell’s palsy. In: Sanus GZ, Batıoğlu Karaaltın A, eds. Surgical Management of Facial Nerve Paralysis. 1st ed. Ankara: Türkiye Klinikleri; 2022. p.82-5.

Article Language: EN

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.

Keywords: Bell’s palsy; facial nerve; facial nerve decompression

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