Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience
Abstract Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary ref...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2018-01-01
|
| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40463-017-0250-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832568841423552512 |
|---|---|
| author | Ilyes Berania Mohamed Awad Issam Saliba Jean-Jacques Dufour Marc-Elie Nader |
| author_facet | Ilyes Berania Mohamed Awad Issam Saliba Jean-Jacques Dufour Marc-Elie Nader |
| author_sort | Ilyes Berania |
| collection | DOAJ |
| description | Abstract Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CA |
| format | Article |
| id | doaj-art-5bd38e29192a4cc984ab1d3493aa13a4 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-5bd38e29192a4cc984ab1d3493aa13a42025-02-03T00:22:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162018-01-014711710.1186/s40463-017-0250-yDelayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experienceIlyes Berania0Mohamed Awad1Issam Saliba2Jean-Jacques Dufour3Marc-Elie Nader4Division of Otolaryngology - Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l’Université de Montréal (CHUM) – Hôpital Notre-DameDivision of Otolaryngology - Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l’Université de Montréal (CHUM) – Hôpital Notre-DameDivision of Otolaryngology - Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l’Université de Montréal (CHUM) – Hôpital Notre-DameDivision of Otolaryngology - Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l’Université de Montréal (CHUM) – Hôpital Notre-DameDivision of Otolaryngology - Head and Neck Surgery, Université de Montréal, Centre Hospitalier de l’Université de Montréal (CHUM) – Hôpital Notre-DameAbstract Background This study aims to assess the effectiveness of delayed facial nerve decompression for Bell’s palsy (BP). Methods We performed a retrospective case review of all patients having undergone facial nerve decompression for severe refractory BP between 1984 and 2009 at our tertiary referral center. Demographics, timing between onset of symptoms and surgical decompression, degree of facial nerve dysfunction pre- and post-operatively, follow-up length after surgery and postoperative complications were recorded. Facial nerve dysfunction was assessed using the House-Brackmann (HB) scale. Electroneuronography, electromyography and imaging results were assessed when available. Results Eighteen patients had surgery between 21 and 60 days after onset of BP (group I), and 18 patients had surgery more than 60 days after onset of symptoms (group II). In group II, 11 patients had surgery between 61 and 89 days and 7 patients after 90 days. Groups I and II showed similar functional gain and rates of improvement to HB 3 or better (11/18 vs. 11/18, p > 0.05). In group II, patients operated 60 to 89 days after onset of BP showed a significantly higher rate of improvement to HB 3 or better (9/11 vs. 2/6, p = 0.049) with higher functional gain compared to those operated after 90 days (p = 0.0293). Conclusions When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings. Trial registration Retrospective registered. IRB# 2016–6154, CE 15.154 – CAhttp://link.springer.com/article/10.1186/s40463-017-0250-yBell’s palsySurgical decompressionFacial nerveFunctional outcomes |
| spellingShingle | Ilyes Berania Mohamed Awad Issam Saliba Jean-Jacques Dufour Marc-Elie Nader Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience Journal of Otolaryngology - Head and Neck Surgery Bell’s palsy Surgical decompression Facial nerve Functional outcomes |
| title | Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience |
| title_full | Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience |
| title_fullStr | Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience |
| title_full_unstemmed | Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience |
| title_short | Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience |
| title_sort | delayed facial nerve decompression for severe refractory cases of bell s palsy a 25 year experience |
| topic | Bell’s palsy Surgical decompression Facial nerve Functional outcomes |
| url | http://link.springer.com/article/10.1186/s40463-017-0250-y |
| work_keys_str_mv | AT ilyesberania delayedfacialnervedecompressionforsevererefractorycasesofbellspalsya25yearexperience AT mohamedawad delayedfacialnervedecompressionforsevererefractorycasesofbellspalsya25yearexperience AT issamsaliba delayedfacialnervedecompressionforsevererefractorycasesofbellspalsya25yearexperience AT jeanjacquesdufour delayedfacialnervedecompressionforsevererefractorycasesofbellspalsya25yearexperience AT marcelienader delayedfacialnervedecompressionforsevererefractorycasesofbellspalsya25yearexperience |