Study on the relationship between the assessment of facial muscle function and prognosis of Bell's palsy

Xiongguang LIU; Yuning SU

ABSTRACT

BACKGROUND:

There has been no definite cause for Bell's palsy. Different kinds of causes and courses always lead to different outcomes. Up to now there has not been to accord on the relationship between assessment of facial muscle function and prognosis of Bell's palsy.

OBJECTIVE:

To explore the relationship between level diagnosis, blink reflex(BR) , electroneurography(ENoG) and prognosis in order to find the timing for treatment of Bell's palsy.

DESIGN:

A self-control study.

SETTING:

Department of otolaryngology, Beihai People's Hospital,Guangxi Zhuang Autonomous Region.

PARTICIPANTS:

There were 42 cases of Bell's palsy that were in accordance with the diagnosis criteria and hospitalized in the Beihai People's Hospital from January 1989 to December 1999. Thirty-six cases out of the 42 were well documented and thus were studied here.

METHODS:

Level diagnosis, BR and EnoG test as well as facial muscle assessment were conducted on thirty-six patients with Bell's palsy.

RESULTS:

Patients with facial function score under 11 and with the lesion at D segment had poor results in BR and ENoG test. The outcome of conservative treatment for these patients was also bad. That would be improved by facial nerve decompression. The results of examination within one month after palsy onset were correlated with prognosis ( P ＞ 0. 05) . Two cases received decompression on the 40th day onset and recovered completely. Two cases Received decompression in the 2nd month, one recovered completely and decompression and recovered partially.

CONCLUSION:

Patients with the following manifestations may make conplete recovery after conservative treatment lesion distal to segment D, facial function over 11 marks, presence of R1 wave by BR test in the 1st month and fiber deprivation ＜ 90% by ENoG. Facial nerve decompression should be taken for patients in a condition other than that.