ENTRAPMENT NEUROPATHY IN ACUTE FACIAL PARALYSIS ; CIRCURATORY DISTURBANCE AND ITS TREATMENT

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There have been scant information on circulation of the facial nerve under compression. Aim of the research was to study histologic evidence of compression of the vessels, and treatment to overcome the compression produced in the temporal bone. A infused resin study showed that vessels were hardly identifiable at the stage of miximum swelling. In normal guinea pigs and after administration of glycerol, vessels were identifiable in peri-and epineurium. There are communicative routes between the CSF and interstitial space of the facial nerve. Microspheres passing study showed that the route closed at initial swelling stage of palsy. After administration of glycerol, the route reopened.The glycerol had effective only 24 hours with single shot mainly in the geniculate ganglion area. Serial administration is necessary. Taking off the canal at the time of nerve damage not only reduced the incidence of palsy, but also severe palsy. In clinical cases, decompression within 7 days of onset of the palsy reduced the cases recovered with pathologic synkinesis. To prevent circulatory disturbance of the nerve, we proposed early total facial nerve decompression ; medically in the labyrinthine and geniculate segment, and surgically in the tympanic and mastoid segment.