Surgical Outcomes in Idiopathic Recurrent Facial Nerve Paralysis: A Rare Clinical Entity

ObjectiveTo evaluate the postoperative facial nerve dysfunction, audiometric outcomes, and long‐term quality‐of‐life outcomes of patients with idiopathic recurrent facial nerve paralysis (RFP) after middle cranial fossa (MCF) microsurgical decompression.MethodsRetrospective chart analysis of 11 (mean age 37.0 years, range 5 to 67) patients at an academic tertiary referral center who underwent MCF facial nerve decompression. Data analysis included evaluation of pre‐ and postoperative House‐Brackmann (HB) score, pre‐ and postoperative pure‐tone average (PTA), pre‐and postoperative word recognition scores (WRS), and postoperative Facial Clinimetric Evaluation survey.ResultsMean number of preoperative facial paralysis episodes was 3.5 (range 2 to 6), and preoperative HB score was 4.5 (range 1 to 6). Postoperatively, 0 patients had further episodes of facial nerve paralysis at an average of 6.5 years (range 0.1 to 17.6) (P = 0.005), and the average postoperative HB score was 2.1 (range 1 to 3) (P = 0.011). Postoperative audiometry was stably maintained as assessed with PTA and WRS scores.ConclusionMicrosurgical facial nerve decompression for idiopathic RFP may be a reliable therapeutic modality to prophylactically decrease the number of facial nerve paralysis episodes and may also help to improve facial nerve functional status.Level of Evidence4 Laryngoscope, 130:200–205, 2020