The surgical management of Bell's palsy: A review

Facial nerve paralysis is a devastating problem for those affected. Few are as in otolaryngology have been as controversial as the management of Be:ll' s palsy. The past several decades have witnessed many theories about the et iology and pathogenesis of Bell's palsy. In concert with each of these theo ries has been an appropriate management scheme. Because of the nature of th e literature, it has been difficult for clinicians to unequivocally outline management algorithms. In the forefront of this debate is the issue of sur gical therapy for a subset of these patients. Recent technology has provide d some concrete insights into the mechanisms underlying Bell's palsy. Furth er, new clinical studies, albeit retrospective, support the need to re-eval uate surgery in the treatment of selected patients. The literature regardin g the pathophysiology of Bell's palsy and the history of facial nerve surge ry for this disease are reviewed.