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Related Experiment Videos

Does the stapes reflex remain the same after Bell's palsy?

F N Ardiç1, I Topaloğlu, S Oncel

  • 1Department of Otolaryngology-Head and Neck Surgery, Pamukkale University, School of Medicine, Denizli, Turkey.

The American Journal of Otology
|December 10, 1997
PubMed
Summary

Facial paralysis, particularly severe Bell's palsy (grade IV), can cause permanent partial denervation of the stapedial nerve, impacting stapes muscle function at high sound intensities. This study assessed nerve integrity one year post-paralysis.

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Area of Science:

  • Otolaryngology
  • Neurology
  • Audiology

Background:

  • Facial paralysis, commonly Bell's palsy, affects the facial nerve (CN VII).
  • The nervus stapedius, a branch of the facial nerve, controls the stapedius muscle, crucial for auditory modulation.
  • Long-term functional integrity of the nervus stapedius after facial paralysis is not well understood.

Purpose of the Study:

  • To investigate the functional integrity of the nervus stapedius one year after facial paralysis.
  • To assess the impact of facial paralysis severity on stapedial nerve function.
  • To evaluate for synkinetic reinnervation patterns.

Main Methods:

  • Prospective study of 32 Bell's palsy patients and 10 healthy controls over one year.
  • Acoustic reflex testing (500 and 1,000 Hz at 80-110 dB) performed in normal, eye-closed, and grin positions.

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  • Impedance audiometry measured middle ear response amplitude differences between affected and unaffected ears.

    • Main Results:

    • Significant differences in acoustic reflex amplitude were observed between grade IV facial paralysis patients and controls at 100 and 110 dB (p < 0.05).
    • No significant differences were found between grade II or III patients and the control group.
    • Stapes reflex thresholds were not affected, and no synkinetic innervation was detected.

    Conclusions:

    • Severe facial paralysis (grade IV) can lead to permanent partial denervation of the stapedial nerve.
    • This denervation affects stapedius muscle function, particularly with high-intensity sounds.
    • The stapedial nerve's functional integrity can be assessed one year post-paralysis using acoustic reflex testing.