Bell's palsy—prognostic value of the stapedius reflex with contralateral stimulation

Abstract

The stapedius reflex using contralateral stimulation is a test familiar to most ENT[ear, nose and throat]-specialists. The test does not discriminate very well between a good and a poor prognosis in patients with Bell''s palsy, since too many of the patients who may recover spontaneously lack the reflex at an early stage of the disease. It may be of great value as a complement to other tests in establishing the prognosis. Its presence during the first 10 days of the disease indicates a good prognosis. Its absence cannot be used for prognostic purposes by itself. The stapedius reflex can be elicited even in patients with total or subtotal facial paralysis and these patients may recover completely. Although it is dependent upon a motor division of the facial nerve the stapedius reflex may regain its power in 2 mo. even if facial function does not return completely. This might indicate that it is more a reflection of the severity of the disease of the entire facial nerve than merely a test to locate the point of damage.