May M, Klein S R, Taylor F H
Laryngoscope. 1985 Apr;95(4):406-9. doi: 10.1288/00005537-198504000-00007.
Idiopathic (Bell's) facial palsy is a self-limiting, non-life threatening, and spontaneously remitting disorder. The natural history of Bell's palsy is favorable: 84% of 1011 patients with Bell's palsy studied by one investigator recovered satisfactorily without treatment, and no valid clinical trials conducted to date have provided definitive evidence that treatment with steroids or surgery improves upon this figure. The authors studied 273 patients with Bell's palsy to evaluate the prognostic significance of evoked electromyography in predicting the possible benefit of transmastoid facial nerve surgical decompression. The results indicated that even when evoked electromyography was used to select those patients who might benefit most from transmastoid surgery, outcome in patients treated surgically was no better than can be expected to occur without treatment. Based upon these observations, transmastoid facial nerve surgery is not recommended to treat Bell's palsy because no benefits have been identified which outweigh the risks of surgery.
特发性（贝尔氏）面瘫是一种自限性、非危及生命且可自发缓解的疾病。贝尔氏面瘫的自然病程良好：一位研究者对1011例贝尔氏面瘫患者进行研究，其中84%未经治疗即获得满意恢复，并且迄今为止所进行的有效临床试验均未提供确凿证据表明使用类固醇或手术治疗能改善这一比例。作者对273例贝尔氏面瘫患者进行研究，以评估诱发肌电图在预测经乳突面神经手术减压可能获益方面的预后意义。结果表明，即便使用诱发肌电图来挑选那些可能从经乳突手术中获益最大的患者，接受手术治疗的患者的结局并不比未经治疗预期出现的结局更好。基于这些观察结果，不建议采用经乳突面神经手术来治疗贝尔氏面瘫，因为尚未发现有任何益处超过手术风险。
