Indications of Facial Nerve Decompression

Abstract

The indications of facial nerve decompression were discussed based on our 15 years of cinical ex-perience. In Bell's palsy and Hunt syndrome, the indications of facil nerve decompression remain controversial. Although facial palsy with severe denervation is generally indicated for decompression surgery, the optimal timing of the operation and the method of approach remain in question since the efficacy of such decompression is often less than satisfactory. Recently, few patients with Bell's palsy and Hunt syndrome are thus indicated for decompression, owing to the recent success of high - dose steroid therapy developed by Stennert. It should also be noted, however, that patients with recurrent facial palsy, who are considered to have Bell's palsy, are often dignosed to have facial neurinoma. In facial neurinoma and traumatic facial palsy, better results can be expected by decompression without a damaged nerve and tumor resection than by nerve transplantation after a damaged nerve and tumor resection, when the continuity of the remnant facial nerve fiber can be maintained. Facial palay due to cholesteatoma is considered to be clearly indicated for decompression and tym-panoplasty.