Idiopathic recurrent facial palsy: Facial nerve decompression via middle cranial fossa approach.

Objective: To introduce our experience of preventing further episodes of idiopathic recurrent facial palsy by facial nerve decompression via middle cranial fossa approach.

Methods: Twelve cases (surgery group) who had idiopathic recurrent facial palsy underwent facial nerve decompression via middle cranial fossa approach, and 6 cases (control group) who declined surgery accepted conservative treatment. Further episodes of facial palsy and final outcomes of facial nerve were recorded. Facial nerve function was assessed by House-Brackmann facial nerve grade system.

Results: Only 8.3% of the patients (one case) in the surgery group had further episodes of facial palsy on the surgical side, but up to 64.7% of the patients (4 cases) in the control group suffered further episodes (p<0.05). 11 patients (91.7%) in the surgery group recovered to Grade I or Grade II in contrast to 3 cases (50%) in the control group.

Conclusions: Facial nerve decompression via middle cranial fossa approach was able to prevent further episodes of idiopathic recurrent facial palsy, and surgical decompression seemed to achieve better outcomes of facial nerve than conservative treatment.