Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T08:55:42.805Z Has data issue: false hasContentIssue false
  • English
  • Français

Recurrent facial nerve palsy: the role of surgery

Published online by Cambridge University Press:  17 June 2010

J Doshi  and
R Irving
J Doshi*
Affiliation:
ENT Department, Queen Elizabeth Hospital, Birmingham, UK
R Irving
Affiliation:
ENT Department, Queen Elizabeth Hospital, Birmingham, UK
*
Address for correspondence: Mr Jayesh Doshi, ENT Department, c/o Mr Irving's Secretary, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. Fax: +44 (0)121 627 2291 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Repeated episodes of acute idiopathic facial paralysis present both a diagnostic and a management dilemma. We discuss these issues with reference to four adult cases managed between 1999 and 2008, thus adding to the sparse literature on this subject. For such cases, our unit performs decompression of geniculate, labyrinthine and meatal segments of the facial nerve via a middle fossa approach. A short video, available on The Journal of Laryngology & Otology website, demonstrates the key stages of the operation.

We believe there is a role for surgical decompression in cases of recurrent acute facial weakness with three or more documented episodes, especially in the presence of progressive deterioration in function. Decompression of the geniculate, labyrinthine and meatal segments, via a middle fossa approach, is our favoured technique, and has achieved good results.

Keywords

Facial NerveDecompression, SurgicalFacial Paralysis
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 11 , November 2010 , pp. 1202 - 1204
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the XI Facial Nerve Symposium, Rome 25–28 April 2009, Rome, Italy, and at the Politzer Meeting, London 3–5 September 2009, London, UK.

References

1 Yanagihara, N, Mri, H, Kozawa, T, Nakamura, K, Kita, M. Bell's palsy: nonrecurrent v recurrent and unilateral v bilateral. Arch Otolaryngol 1984;110:374–7CrossRefGoogle ScholarPubMed
2 Pitts, DB, Adour, KK, Hilsinger, RL Jr. Recurrent Bell's palsy: analysis of 140 patients. Laryngoscope 1988;98:535–40CrossRefGoogle ScholarPubMed
3 Zaytoun, GM, Dagher, WI, Rameh, CE. Recurrent facial nerve paralysis: an unusual presentation of fibrous dysplasia of the temporal bone. Eur Arch Otorhinolaryngol 2008;265:255–9CrossRefGoogle ScholarPubMed
4 Motamed, M, Pau, H, Daudia, A, Narula, A. Recurrent facial nerve palsy on flying. J Laryngol Otol 2000;114:704–5CrossRefGoogle ScholarPubMed
5 Clement, WA, White, A. Idiopathic familial facial nerve paralysis. J Laryngol Otol 2000;114:132–4CrossRefGoogle ScholarPubMed
6 Yetiser, S, Satar, B, Kazkayasi, M. Immunologic abnormalities and surgical experiences in recurrent facial nerve paralysis. Otol Neurotol 2002;23:772–8CrossRefGoogle ScholarPubMed
7 Manos-Pujol, M, Buendia, E, Mestre, M, Jimenéz, R, Gil, E, Menén, JP et al. Cellular immunity abnormalities in patients with recurrent Bell's palsy. Clin Otolaryngol 1987;12:283–7CrossRefGoogle ScholarPubMed
8 Durelli, L, Cocito, D, Delsedime, M. The Melkersson-Rosenthal syndrome: a case with increased CNS IgG synthesis. Ann Neurol 1985;18:623CrossRefGoogle ScholarPubMed
9 Bruns, AD, Burgess, LP. Familial recurrent facial paralysis: four generations. Otol Head Neck Surg 1998;118:859–62CrossRefGoogle ScholarPubMed
10 Boddie, HG. Recurrent Bell's palsy. J Laryngol Otol 1972;86:117–20CrossRefGoogle ScholarPubMed
11 Ralli, G, Magliulo, G. Bell's palsy and its recurrences. Arch Otorhinolaryngol 1988;244:387–90CrossRefGoogle ScholarPubMed
12 Mamoli, B, Neumann, H, Ehrmann, L. Recurrent Bell's palsy: etiology, frequency, prognosis. J Neurol 1977;216:119–25CrossRefGoogle ScholarPubMed
13 Kartush, JM, Lilly, DJ, Kemink, JL. Facial electroneurography: clinical and experimental investigations. Otolaryngol Head Neck Surg 1985;93:516–23CrossRefGoogle ScholarPubMed
14 Canale, TJ, Cox, RH. Decompression of the facial nerve in Melkersson syndrome. Arch Otolaryngol 1974;100:373–4CrossRefGoogle ScholarPubMed
15 Kettel, K. Peripheral facial palsy. In Pathology and Surgery. Copenhagen: Munksgaard, 1959Google Scholar
16 Tamaki, H, Ogino, S, Miyaguchi, M. Recurrent facial palsy. In: Graham, MD, House, WF, eds. Disorders of the Facial Nerve. New York: Raven Press, 1982;243–8Google Scholar
17 Dutt, SN, Mirza, S, Irving, R, Donaldson, I. Total decompression of facial nerve for Melkersson-Rosenthal syndrome. J Laryngol Otol 2000;114:870–3CrossRefGoogle ScholarPubMed
18 Graham, MD, Kartush, JM. Total decompression for recurrent facial nerve paralysis: an update. Otolaryngol Head Neck Surg 1989;101:442–4CrossRefGoogle ScholarPubMed
19 Nyberg, P, Fisch, U. Surgical treatment and results of idiopathic recurrent facial nerve palsy. In: Portmann, M, ed. Facial Nerve. New York: Masson, 1985;259–68Google Scholar
20 Graham, MD, Kemink, JL. Total facial nerve decompression in recurrent facial paralysis and the Melkersson-Rosenthal syndrome: a preliminary report. Am J Otol 1986;7:34–7Google ScholarPubMed

Doshi supplementary material

Movie.mp4

Download Doshi supplementary material(Video)
Video 11.8 MB