Décompression du nerf facial

Place de la décompression chirurgicale du nerf facial dans les

PFP

Paralysie Faciale Périphérique

• Aiguë ou progressive• APC, Intrapétreux,

Extracrânien

• Traumatiques• Tumorales• Infectieuses

Diagnostic

Prise en charge

Médicale

Décompression chirurgicale

Traumatiques

Iatrogènes

Tumorales

Infectieuses

Virales

Late facial nerve decompression surgery

based on MRI

M. Bruzzo, N. Girard, R. Meller, A. Chays, J. MagnanCHU Nord - Marseille - France

IX ’th International Facial Nerve Symposium

San Francisco - July 2001

• 307 patients with acute facial palsy

• 63 complete palsy

• 24 unrecovered palsy

– 1 patient with normal MRI

– 23 patients with MRI enhancement

Surgical population 1990 - 2000

n = 18

• Complete clinically and electrically paralysis with MRI-enhancement of the homolateral facial nerve

• symptoms duration : 2,98 months

• Ramsay-Hunt eruption : 8

MRI Data

0

5

10

15

20

IC LP GG TP MP

Surgery

No surgery

Outcomes

02468

101214

HB I HBII

HBIII

HBIV

HBV

HBVI

Preop

Immediate Postop

6 months Postop

Not operated

Correlations

0

5

10

15

20

IC LP GG TP MP

MRI

Decompression

Inflammation

Outcomes

• Preoperative

– 4 grade IV

– 11 grade V

– 3 grade VI

• Postoperative

– 11 grade II

– 6 grade III

– 1 grade IV