Subtotal facial nerve decompression for recurrent facial palsy in Melkersson Rosenthal syndrome

Abstract

Conclusions: Subtotal facial nerve decompression seems effective to prevent further episodes of facial palsy and promote facial nerve recovery for recurrent facial palsy in Melkersson Rosenthal syndrome (MRS). The main inflammatory sites of recurrent facial palsy in MRS may be the mastoid segment, tympanic segment, geniculate ganglion, and labyrinthine segment. Objective: To present our surgical experience in preventing further episodes of facial palsy and improving facial nerve recovery of patients with recurrent facial palsy in MRS. Methods: We performed transmastoid subtotal facial nerve decompression on eight patients with recurrent facial palsy in MRS. They were followed up for 3.3 years on average (range 2–5 years). Results: There were no further attacks of facial palsy in any of the cases. Seven cases (87.5%) recovered to grade I or grade II, and three of eight cases (37.5%) recovered completely. We found obvious edema of the facial nerve at the mastoid segment in all cases, at the tympanic segment and geniculate ganglion in five cases (62.5%), and at the labyrinthine segment in only one case (12.5%).

Keywords::

• Facial nerve function
• inflammatory site
• mastoid segment
• tympanic segment
• geniculate ganglion
• labyrinthine segment

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.