A case of bilateral alternating Bell's palsy treated by decompression of the bilateral facial nerves

Abstract

We experienced a case of Bell's palsy with bilateral alternating recurrence at intervals of half a year. We performed decompression of the bilateral facial nerves by a transmastoidal approach in consideration of the surgical indication criteria of our department and the patient's wishes. The patient was completely satisfied with the effect at the one-year follow-up after the surgeries. However, while the Yanagihara grading score on the initially paralyzed side recovered from 8 points to 34 points by 6 months after the first surgery, electroneurography (ENoG) did not reveal any recovery of the compound muscle action potential, so it was difficult to evaluate the surgical effect by ENoG in this case. It is difficult to predict the prognosis of alternating recurrence of Bell's palsy using ENoG by the general method. We therefore intend to adopt the midline method as well in the future.