Surgical treatment of Bell's palsy

In 17 patients with Bell's palsy not treated or not responding to conservative therapy, vertical and horizontal decompressions were performed between days 7 and 10, relying primarily on the findings of neuromyography. Four patients (23.5%) recovered fully. Further 35 patients were operated after the regeneration period for absence of reinnervation signs between the 3rd to 6th months. An unusually marked and rapid improvement was noted in a 20-year-old female patient. In a 49-year-old male patient a neurinoma was found on the tympanal section of the facial nerve. Residual symptoms were significantly milder after early and late decompressions compared to spontaneous recovery of paralysis associated with total degeneration. There was no difference between the two operated groups.