Considerations on Surgical Indications for Intratemporal Facial Paralysis

概要

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A lesion within the temporal bone is responsible for 90 per cent of all the cases of peripheral facial paralysis, so that it is the otologist's duty to undertake the investigation and treatment of them.From the point of up-to-date electrodiagnosis as well as Seddon's classification of nerve injuries, changing concepts about the indications for surgical decompression of the facial nerve are reviewed.We have arrived at the following conclusions I. Life-saving decompression: —Saving the nerve fibers from degenerating, decompression should be done before it is too late (by the seventh, at the latest the fourteenth day), as soon as loss of nerve excitability occurs.II. Life-giving decompression: —Activating the "potential" vitalities of injured nerve to the "actual" ones, decompression should be done when and after fibrillations are found. The term of validity usually covers from a few weeks to a few months, exceptionally extends over a few years from the onset of the paralysis.Now we would be inclined to say daringly: "Facial paralysis, a medical emergency; if the facial nerve starts losing its excitability, then a surgical emergency!"
耳鼻咽喉科臨床学会の論文