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

Bodénez, C.; Bernat, Isabelle; Willer, Jean Claude; Barré, Philippe; Lamas, G.; Tankéré, F.

doi:10.1017/s0022215109991265

Cited by 31 publications

(29 citation statements)

References 36 publications

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“…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). …”

Section: Discussionsupporting

confidence: 61%

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

Vianna¹,

Adams²,

Schachern³

et al. 2014

Otology &Amp; Neurotology

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Bell's palsy is hypothesized to result from virally mediated neural edema. Ischemia occurs as the nerve swells in its bony canal, blocking neural blood supply. Because viral infection is relatively common and Bell's palsy relatively uncommon, it is reasonable to hypothesize that there are anatomic differences in facial canal (FC) that predispose the development of paralysis. Measurements of facial nerve (FN) and FC as it follows its tortuous course through the temporal bone are difficult without a 3D view. In this study, 3D reconstruction was used to compare temporal bones of patients with and without history of Bell's palsy. Methods Twenty-two temporal bones (HTBs) were included in the study, 12 HTBs from patients with history of Bell's palsy and 10 healthy controls. Three-dimensional models were generated from HTB histopathologic slides with reconstruction software (Amira), diameters of the FC and FN were measured at the midpoint of each segment. Results The mean diameter of the FC and FN was significantly smaller in the tympanic and mastoid segments (p = 0.01) in the BP group than in the controls. The FN to FC diameter ratio (FN/FC) was significantly bigger in the mastoid segment of BP group, when compared with the controls. When comparing the BP and control groups, the narrowest part of FC was the labyrinthine segment in control group and the tympanic segment in the BP. Conclusion This study suggests an anatomic difference in the diameter of FC in the tympanic and mastoid segments but not in the labyrinthine segment in patients with Bell's palsy.

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Section: Discussionsupporting

confidence: 61%

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

Vianna¹,

Adams²,

Schachern³

et al. 2014

Otology &Amp; Neurotology

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“…In general, facial nerve decompression is recommended for patients within 2 weeks of onset of Bell's palsy (5,10). However, delayed decompression 3 months or lesser after onset has been shown to relieve the sequelae of Bell's palsy (6).…”

Section: Discussionmentioning

confidence: 99%

Measurement of the Facial Nerve Caliber in Facial Palsy

Hagino¹,

Tsunoda²,

Tsunoda³

et al. 2011

Otology &Amp; Neurotology

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“…However, in dystonia there is no significantly efficient alternative treatment other than deep brain stimulation, which is reserved for the most severe forms of cervical dystonia [10,12,15,19]. In facial hemispasm, decompression surgery is effective [2,20] but it is more invasive and is usually not used as first intention therapy. On the other hand, many alternative techniques and pharmacological treatments have been used in spasticity and further studies are required comparing [1,22,23].…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study

et al. 2011

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Botulinum toxin (BTA) is a safe and effective therapeutic tool for many neurological conditions but few studies have investigated its real cost in neurological practice. We evaluated the daily cost of botulinum toxin type A (BTA) treatment through a cost effectiveness analysis alongside a prospective study of BTA injections at a French University Hospital over a 2-year follow-up period. The data of 3,108 BTA injections performed in 870 adult patients presenting with dystonia, facial hemispasm, or spasticity were entered in the database. Patients were questioned at each visit about the subjective effectiveness of the previous injection. The daily cost of BTA treatment was calculated as the ratio of each session's cost (including all additional costs) to the duration of subjective efficacy. The subjective rating of efficacy duration was 17.3 ± 7.7 weeks for facial hemispasm, 15.4 ± 7.7 for blepharospasm, 14.3 ± 6.7 for cervical dystonia, 14.5 ± 7.8 and 14.1 ± 7.4 weeks for upper and lower limb spasticity, respectively. The daily cost of BTA injections was 0.57 ± 0.20 for facial hemispasm, 0.95 ± 0.30 for blepharospasm, 2.85 ± 0.86 for cervical dystonia, 3.38 ± 1.49 and 3.62 ± 1.81 for upper and lower limb spasticity, respectively. When associated costs were considered, the daily cost of BTA injections was clearly increased (45-93%) in limb spasticity or rigidity but remained only modestly increased (15-37%) in other indications. These results obtained in a large cohort of patients show that BTA treatment has a low daily cost for a long-lasting effect, with a daily cost/benefit ratio that greatly depends on the indications.

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

Abstract: These results compared favourably with previous reports. A new therapeutic procedure may allow improved results.

Cited by 31 publications

References 36 publications

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

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

Measurement of the Facial Nerve Caliber in Facial Palsy

Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study

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