Facial nerver decompression

McNeill, Roger

doi:10.1017/s0022215100078919

Cited by 17 publications

(9 citation statements)

References 49 publications

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“…After identification and screening, 13 studies were assessed for eligibility. As indicated in Table 1, six studies were excluded because they used evaluation methods that were different from the HBGS or May’s classification (n=5) [9,14-17] and one study was further excluded, including presumed duplicate cohort, with subsequent studies published by the same author [18]. Ultimately, seven studies were selected for quantitative and qualitative analysis [8,13,19-22].…”

Section: Resultsmentioning

confidence: 99%

Clinical Implication of Facial Nerve Decompression in Complete Bell’s Palsy: A Systematic Review and Meta-Analysis

Lee

Seong

Kim

2019

Clin Exp Otorhinolaryngol

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We compared the therapeutic efficacy of facial nerve decompression (FND) and conservative treatment in patients with Bell’s palsy through a systematic review and meta-analysis. Primary database search was performed in PubMed, Medline, and Embase. After screening, 13 studies were assessed for their eligibility. Among them, seven studies employing either the House-Brackmann grading system (HBGS) or May’s classification (modified HBGS) were selected for quantitative and qualitative analysis. Based on May’s classification, the degree of recovery was classified into complete (HBGS I), fair (HBGS II–III), or failed (HBGS IV–VI) recovery. The outcomes were assessed between 6 and 12 months after surgery. The estimated pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects model. Cohorts were comprised of patients who underwent FND (n=202, 53.0%) and conservative treatments (n=179, 47.0%). In pooled analysis, the rate of complete recovery was significantly higher in the FND group than in the control group (OR, 2.06; 95% CI, 1.22 to 3.48; P=0.007) showing neither heterogeneity nor publication bias. Meanwhile, the rates of fair recovery (OR, 0.71; 95% CI, 0.42 to 1.21; P=0.208) and failed recovery (OR, 0.60; 95% CI, 0.22 to 1.67; P=0.327) in the FND group were similar to that in the control group. In subgroup analyses, there was no significant difference in the OR according to the operation timing and surgical approach. FND can be a possible treatment option for patients with complete Bell’s palsy, especially for complete recovery, which provide insights on decision-making and outcome prediction. However, FND should be determined carefully given the risk of small study effects and possible complications.

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Section: Resultsmentioning

confidence: 99%

Clinical Implication of Facial Nerve Decompression in Complete Bell’s Palsy: A Systematic Review and Meta-Analysis

Lee

Seong

Kim

2019

Clin Exp Otorhinolaryngol

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“…Surgical decompression of the facial nerve has been widely accepted in the treatment of facial paralysis by opening the facial canal. 4 But facial nerve paralysis following this type of surgery causes great psychologic trauma for patients. In the transmastoid approach, it is simple and easy to expose the vertical and partial tympanic segment of the facial nerve.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Landmarks for Localization of the Vertical Segment of Facial Nerve on Multislice CT Multiplanar Reconstruction Images

Ren

Bai

et al. 2015

Journal of Craniofacial Surgery

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The facial nerve decompression via mastoid is simple and easy to expose the vertical segment of the facial nerve (VFN). The objective of this study was to find out the relationship between the VFN and anatomic landmarks to facilitate prediction of the location of VFN during facial nerve decompression. The different landmarks were cochlear window (CW), oval window (OW), promontorium tympani (PT), and mastoid antrum (MA). Parameters of 140 patients (280 observations) with healthy middle ears were measured on high-resolution spiral multislice computed tomographic multiplanar reconstruction (MPR) images that were parallel to the base plane. The data gained were analyzed by statistical method and were also analyzed with respect to side and gender. The angle between orientation of VFN to the CW of the longest distance and horizontal axis was larger on the left side than that of the right (P < 0.05). Our results may provide more detailed information to predict the location of VFN during facial nerve decompression through mastoid.

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“…In addition, other studies have shown no benefit and other authors were sceptical. 7,8,27,55,86,97,98 Conclusion 95,96 With regard to question two, does decompression surgery ameliorate the outcome in severe cases that do not show improvement with medical therapy, we conclude that decompression surgery, performed for the right indication, by the most skilful surgeons, might be effective in preventing sequelae (Table V).…”

Section: Decompression Surgerymentioning

confidence: 92%

“…7,26 Many authors have described the swollen nerve. 7,26 Many authors have described the swollen nerve.…”

Section: Pathophysiologymentioning

confidence: 99%

“…21,29,46,84 Theoretically, the only hope of restoring bilaterally co-ordinated emotional expression after paralysis of the facial nerve lies in restoration of the functional integrity of that nerve. 8,27,[86][87][88] From reports by McNeill, 7 Gantz et al, 8 Yanagihara et al 89 and Alford et al, 90 it is clear that the timing and extent of decompression are of utmost importance for the recovery and development of sequelae. It should be preserved for special cases; it is more relevant in patients who are less likely to recover spontaneously.…”

Section: Decompression Surgerymentioning

confidence: 99%

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Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

Brennan

Martens

2015

J. Laryngol. Otol.

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Facial nerver decompression

Cited by 17 publications

References 49 publications

Clinical Implication of Facial Nerve Decompression in Complete Bell’s Palsy: A Systematic Review and Meta-Analysis

Clinical Implication of Facial Nerve Decompression in Complete Bell’s Palsy: A Systematic Review and Meta-Analysis

Anatomic Landmarks for Localization of the Vertical Segment of Facial Nerve on Multislice CT Multiplanar Reconstruction Images

Antiviral agents convey added benefit over steroids alone in Bell's palsy; decompression should be considered in patients who are not recovering

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