Kim Yong, Yeo Seung Geun, Rim Hwa Sung, Lee Jongha, Kim Dokyoung, Kim Sung Soo, Park Dong Choon, Byun Jae Yong, Kim Sang Hoon
Department of Rehabilitation Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea.
Department of Otorhinolaryngology, Head and Neck Surgery, College of Medicine, Kyung Hee University, Seoul 02447, Korea.
J Clin Med. 2022 Feb 8;11(3):888. doi: 10.3390/jcm11030888.
(1) Background: The effectiveness of decompression surgery for Bell's palsy is controversial. This study investigated the effects of facial nerve decompression in patients with severe Bell's palsy who were expected to have a poor prognosis. (2) Methods: We retrospectively reviewed 1721 patients with Bell's palsy who visited the Kyung Hee University Hospital between January 2005 and December 2021. Of these, 45 patients with severe Bell's palsy were divided into two groups; 30 patients were treated conservatively with steroids and antiviral agents alone, while 15 patients underwent additional decompressive surgery after the conservative treatment. Outcomes were measured using House-Brackmann (H-B) grade for least 6 months after treatment was finished and conducted until full recovery was achieved. (3) Results: There was no significant difference in the rate of favorable recovery (H-B grade 1 or 2) between the surgery group and the conservative treatment group (75% vs. 70.0%, > 0.05). Although H-B grade improvement occurred in both groups, the degree of improvement was not significantly different between groups. (4) Conclusions: Facial nerve decompression surgery in severe Bell's palsy patients did not significantly improve prognosis beyond that offered by conservative treatment alone. Additional surgical decompression may not be necessary in patients with severe Bell's palsy if they receive sufficient conservative treatment.
(1) 背景：减压手术治疗贝尔面瘫的疗效存在争议。本研究调查了面神经减压术对预后较差的重度贝尔面瘫患者的影响。(2) 方法：我们回顾性分析了2005年1月至2021年12月期间就诊于庆熙大学医院的1721例贝尔面瘫患者。其中，45例重度贝尔面瘫患者分为两组；30例患者仅接受类固醇和抗病毒药物的保守治疗，而15例患者在保守治疗后接受了额外的减压手术。治疗结束后至少6个月使用House-Brackmann（H-B）分级来衡量预后，并持续观察直至完全恢复。(3) 结果：手术组和保守治疗组的良好恢复率（H-B 1级或2级）无显著差异（75%对70.0%，P>0.05）。虽然两组的H-B分级均有改善，但两组之间的改善程度无显著差异。(4) 结论：重度贝尔面瘫患者的面神经减压手术并不能显著改善预后，单纯保守治疗即可。如果重度贝尔面瘫患者接受了充分的保守治疗，则可能无需额外的手术减压。
