Effect of delayed decompression after early steroid treatment on facial function of patients with facial paralysis

Conclusion: The earlier decompression is carried out, the better the result. However, decompression delayed a few days beyond 2 weeks after onset of facial paralysis can benefit the recovery of facial function in patients when combined with early use of steroids with or without antiviral agents. Objectives: To demonstrate the correlation between the time of decompression after the onset of facial paralysis and the facial function after surgery and elucidate the beneficial effect of decompression delayed a few days beyond the 2 week period on recovery of facial function in patients who had received early steroid treatment. Patients and methods: Between April 1994 and December 2007, 91 patients with complete facial paralysis who had received early treatment with steroid with or without antiviral agents were included in the study. An independent sample t test was used to analyze the recovery of facial function in patients receiving surgical decompression at different times after onset of paralysis and medical treatment only. Results: Functional gain according to the House-Brackman (HB) grade was 4.05±0.96 for early decompression, 3.63±0.58 for delayed decompression, 2.90±0.76 for late decompression, and 2.51±0.85 for medical treatment only. Delayed decompression significantly improved the functional outcome of patients compared with late decompression and medical treatment only (p<0.05).