Literature DB >> 29764779

Patients Over 60 Years of Age Have Poor Prognosis in Facial Nerve Decompression Surgery with Preserved Ossicular Chain.

Norio Kondo1, Yukie Yamamura1, Manabu Nonaka1.   

Abstract

OBJECTIVE: We report our retrospective study of the recovery rate of auditory ossicles preserved facial nerve decompression surgery via the transmastoid approach in cases of both an electroneurography score of < 10% and a Yanagihara score of ≤8 in Bell's palsy and Ramsay Hunt syndrome.
MATERIALS AND METHODS: We retrospectively reviewed 47 patients who we were able to follow-up for more than 6 months following the onset of palsy. The recovery rate was defined by the Japan Society for Facial Nerve Research or the Yanagihara score.
RESULTS: Twelve months after palsy onset, the recovery rate was 48.8% (20/41) for all patients, 65.2% (15/23) for patients with Bell's palsy, and 27.8% (5/18) for patients with Ramsay Hunt syndrome. Comparing the clinical efficacy of surgical treatment at 12 months after palsy onset, we observed a statistically significant effect of age. Comparing the Yanagihara scores of patients aged < 60 years with those of patients aged ≥60 years revealed that patients aged ≥60 years had significant poor prognosis, particularly in patients with Ramsay Hunt syndrome, which showed a very low recovery rate (14.3%). We also analyzed six other factors, but none showed statistical significance.
CONCLUSION: The clinical efficacy of surgical treatment of Ramsay Hunt syndrome was inferior to that of Bell's palsy, which is consistent with previous reports. There was a statistically significant difference in the Yanagihara score between patients aged < 60 years and those aged ≥60 years. Particularly, patients with Ramsay Hunt syndrome aged ≥60 years have a very low recovery rate.

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Year:  2018        PMID: 29764779      PMCID: PMC6354488          DOI: 10.5152/iao.2018.4601

Source DB:  PubMed          Journal:  J Int Adv Otol        ISSN: 1308-7649            Impact factor:   1.017


  19 in total

1.  Transmastoid decompression as a treatment of Bell palsy.

Authors:  N Yanagihara; N Hato; S Murakami; N Honda
Journal:  Otolaryngol Head Neck Surg       Date:  2001-03       Impact factor: 3.497

2.  Facial nerve decompression surgery using bFGF-impregnated biodegradable gelatin hydrogel in patients with Bell palsy.

Authors:  Naohito Hato; Jumpei Nota; Hayato Komobuchi; Masato Teraoka; Hiroyuki Yamada; Kiyofumi Gyo; Naoaki Yanagihara; Yasuhiko Tabata
Journal:  Otolaryngol Head Neck Surg       Date:  2011-12-13       Impact factor: 3.497

3.  Prognostic factors of Bell's palsy: prospective patient collected observational study.

Authors:  Takashi Fujiwara; Naohito Hato; Kiyofumi Gyo; Naoaki Yanagihara
Journal:  Eur Arch Otorhinolaryngol       Date:  2013-09-01       Impact factor: 2.503

4.  Total decompression of the facial nerve - superior prelabyrinthine cell tracts approach.

Authors:  Taizo Takeda; Shinji Takebayashi; Akinobu Kakigi; Hiroaki Nakatani; Masashi Hamada
Journal:  ORL J Otorhinolaryngol Relat Spec       Date:  2010-02-24       Impact factor: 1.538

5.  Practice parameter: Steroids, acyclovir, and surgery for Bell's palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.

Authors:  P M Grogan; G S Gronseth
Journal:  Neurology       Date:  2001-04-10       Impact factor: 9.910

6.  Surgical management of Bell's palsy.

Authors:  B J Gantz; J T Rubinstein; P Gidley; G G Woodworth
Journal:  Laryngoscope       Date:  1999-08       Impact factor: 3.325

7.  Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center.

Authors:  Marc H Hohman; Tessa A Hadlock
Journal:  Laryngoscope       Date:  2014-01-15       Impact factor: 3.325

8.  Facial nerve outcomes after middle fossa decompression for Bell's palsy.

Authors:  Richard B Cannon; Richard K Gurgel; Frank M Warren; Clough Shelton
Journal:  Otol Neurotol       Date:  2015-03       Impact factor: 2.311

9.  Yanagihara facial nerve grading system as a prognostic tool in Bell's palsy.

Authors:  Naohito Hato; Takashi Fujiwara; Kiyofumi Gyo; Naoaki Yanagihara
Journal:  Otol Neurotol       Date:  2014-10       Impact factor: 2.311

Review 10.  Surgical interventions for the early management of Bell's palsy.

Authors:  Kerrie McAllister; David Walker; Peter T Donnan; Iain Swan
Journal:  Cochrane Database Syst Rev       Date:  2013-10-16
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