Experimentally controlled facial nerve injuries.

Abstract

THE ETIOLOGY and treatment of Bell's palsy are among the unresolved problems in medicine today. It has been reported that 10% to 20% of patients either do not recover or recover incompletely; some suffer synkinesis or contractures. Therefore, it is of paramount importance to forecast, early in the course of the disease, the final outcome in each patient with this type of facial paralysis. At the present time, many otolaryngologists 1-6 advocate nerve excitability studies as a reliable means of predicting the prognosis of patients with Bell's palsy. These authorities recommend decompression of the facial nerve in patients whose excitability test results suggest degenerative changes are occurring; however, the validity of these concepts has been challenged. 7-9 The purpose of this study was to determine the usefulness of the nerve excitability test as an index of neuronal function when paralysis had been produced by a controlled injury of the facial