Systematic Review of Facial Nerve Outcomes After Middle Fossa Decompression and Transmastoid Decompression for Bell's Palsy With Complete Facial Paralysis

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Geoffrey C CasazzaRichard K Gurgel

Abstract

The surgical timing and approach for patients with Bell's palsy and complete facial paralysis is controversial. A previous meta-analysis demonstrated no benefit from surgical decompression, however, only transmastoid decompression (TMD) was investigated. No study has evaluated both the outcomes of TMD and middle fossa decompression (MFD). Systematic review with meta-analysis. A systematic literature search identifying all studies meeting inclusion criteria and published between 1985 and 2015 was performed. Final House-Brackmann (HB) scores were calculated and compared for TMD, MFD, and medical controls. A meta-analysis was performed to compare MFD less than or equal to 14 days versus MFD more than 14 days, TMD versus medical controls, and surgical therapy (combined MFD and TMD) versus medical controls. Observational studies without a control arm were excluded from the meta-analysis. Average HB scores for MFD less than or equal to 14 days was 1.8, MFD more than 14 days was 2.75, and MFD medical controls was 2.4. For TMD average HB was 2.3 and for TMD medical controls average HB was 2.4. 75% MFD were performed within 14 days of onset while TMD was performed between 15 and 120 days. Meta-analysis demonstrated significantly better ...Continue Reading

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Citations

Mar 30, 2019·Journal of Neurology·Wenjuan ZhangXianqi Li
Aug 4, 2020·Journal of Korean Medical Science·Su Jin Kim, Ho Yun Lee
Sep 7, 2019·Clinical and Experimental Otorhinolaryngology·Sang-Yeon LeeYoung Ho Kim
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Apr 15, 2021·Scientific Reports·Akira InagakiShingo Murakami
Aug 10, 2021·American Journal of Otolaryngology·Zhili WangZhaoyan Wang
Aug 18, 2021·Laryngoscope Investigative Otolaryngology·Philip TouskaSteve Connor
Sep 1, 2021·Brazilian Journal of Otorhinolaryngology·Gulay Guclu AslanSelcuk Surucu

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