Pitts D B, Adour K K, Hilsinger R L
Department of Otolaryngology, Kaiser Permanente Medical Center, Oakland, CA 94611.
Laryngoscope. 1988 May;98(5):535-40. doi: 10.1288/00005537-198805000-00012.
Of 1,700 patients with facial paralysis seen in a retrospective study from 1969 through 1977 and 280 patients seen prospectively from 1983 through 1986, 7.1% had recurrence of Bell's palsy. In this group, the frequency of ipsilateral recurrence was equal to that for contralateral recurrence. The mean age at onset of Bell's palsy was 33.0 years; Bell's palsy recurred a mean of 9.8 years later. Recurrent facial paralysis did not indicate a worse prognosis for recovery regardless of which side was affected. There was no statistical difference between results for male patients or female patients, nor was there a statistically significant sex predominance, except in the age group 10 to 19 years. In our results, computed tomography (CT) scan in patients with recurrent Bell's palsy detected no facial-nerve neuroma. Of 77 patients followed a mean of 33 years after the first episode (range, 2.8 to 60 years), none showed progressive facial-nerve dysfunction or any signs of tumor. We conclude that an ipsilateral recurrence of facial paralysis without documented evidence of a tumor does not warrant a transmastoid decompression of the facial nerve. The results of our analysis were verified prospectively as well as retrospectively. A new classification system is introduced for ease of computer analysis and for simplified discussion of recurrent facial paralysis.
在一项1969年至1977年的回顾性研究中诊治的1700例面瘫患者以及1983年至1986年前瞻性诊治的280例患者中，7.1%出现了贝尔面瘫复发。在该组中，同侧复发频率与对侧复发频率相等。贝尔面瘫的平均发病年龄为33.0岁；贝尔面瘫复发平均在9.8年后。无论哪一侧受累，复发性面瘫均不表明恢复预后更差。男性患者和女性患者的结果之间无统计学差异，也无统计学上显著的性别优势，10至19岁年龄组除外。在我们的研究结果中，复发性贝尔面瘫患者的计算机断层扫描（CT）未检测到面神经神经瘤。在首次发作后平均随访33年（范围为2.8至60年）的77例患者中，无1例出现进行性面神经功能障碍或任何肿瘤迹象。我们得出结论，无肿瘤记录证据的同侧面瘫复发无需进行经乳突面神经减压术。我们分析的结果在回顾性和前瞻性研究中均得到了验证。引入了一种新的分类系统，便于计算机分析和简化复发性面瘫的讨论。
