Treatment of Bell's Palsy

Abstract

Bell''s palsy is the consequence of an anteriolar spasm of the nutrient vessels of the facial nerve. Histologic examination does not show any trace of inflammation, but only of degeneration provoked by compression and edema. Conservative treatment should be directed against the arteriolar spasm and must, therefore, pursue vasodilatation of the feeding arteries. It should be started as soon as possible. In a considerable percentage of the cases, however, conservative treatment does not lead to recovery. By an operative decompression of the diseased nerve, the function of the paralyzed nerve can be restored in quite a large percentage of these patients if not postponed too long. Duration of the palsy is of primary importance for the prognosis. The indications for the operation are discussed. In the series given here 14 out of 15 patients showed a good improvement after operation. Those operated upon within 3 months after the onset of the disease showed a quick and generally total recovery (10 cases). Postponement of the operation results in less favorable prognosis.