Neurogenic concept of bell's palsy. Medical decompression of facial nerve. 1975

V K Misurya

According to the author it is the 'transmyringal' portion of the chorda tympani nerve which in practice remains exposed to the cold atmospheric air and triggers the pathologic process involved in Bell's palsy, affecting the facial nerve secondarily, rather than a primary condition of the facial nerve. This theory was proved by creating a Bell's palsy (paralysis a frigore) with cold-air-stimuli to the tympanic membrane in experimental animals (two monkeys). On the basis of this observation the author recommend's 'medical decompression' of the facial nerve by means of infra-red fomentation of the drum, and eustachian insufflation of hydrocortisone, in cases of Bell's palsy before retrograde extension of oedema from the chorda tympani to the facial nerve can cause irreversible damage. Subsequently, the author has successfully managed fourteen cases (93-4 per cent) of Bell's palsy with a definite history of exposure to cold (paralysis a frigore). It is suggested that the ear canal be plugged with cotton as a preventive measure; and that chorda tympani neurectomy be performed to eliminate the chances of recurrence of the disease in cases of recurrent Bell's palsy.

UI MeSH Term Description Entries
D007259 Infrared Rays That portion of the electromagnetic spectrum usually sensed as heat. Infrared wavelengths are longer than those of visible light, extending into the microwave frequencies. They are used therapeutically as heat, and also to warm food in restaurants. Heat Waves,Heat Wave,Infrared Ray,Ray, Infrared,Rays, Infrared,Wave, Heat,Waves, Heat
D007511 Ischemia A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION. Ischemias
D002814 Chorda Tympani Nerve A branch of the facial (7th cranial) nerve which passes through the middle ear and continues through the petrotympanic fissure. The chorda tympani nerve carries taste sensation from the anterior two-thirds of the tongue and conveys parasympathetic efferents to the salivary glands. Chorda Tympani Nerves,Nerve, Chorda Tympani,Nerves, Chorda Tympani,Tympani Nerve, Chorda,Tympani Nerves, Chorda
D003080 Cold Temperature An absence of warmth or heat or a temperature notably below an accustomed norm. Cold,Cold Temperatures,Temperature, Cold,Temperatures, Cold
D003664 Decompression Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent DECOMPRESSION SICKNESS. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings.
D004424 Ear Canal The narrow passage way that conducts the sound collected by the EAR AURICLE to the TYMPANIC MEMBRANE. Auditory Canal, External,External Acoustic Canal,External Acoustic Meatus,External Auditory Canal,External Ear Canal,Acoustic Canal, External,Acoustic Canals, External,Acoustic Meatus, External,Auditory Canals, External,Canal, Ear,Canal, External Ear,Canals, Ear,Canals, External Ear,Ear Canal, External,Ear Canals,Ear Canals, External,External Acoustic Canals,External Auditory Canals,External Ear Canals
D004430 Ear Protective Devices Personal devices for protection of the ears from loud or high intensity noise, water, or cold. These include earmuffs and earplugs. Earplugs,Hearing Protective Devices,Earmuffs,Device, Ear Protective,Device, Hearing Protective,Devices, Ear Protective,Devices, Hearing Protective,Ear Protective Device,Earmuff,Earplug,Hearing Protective Device,Protective Device, Ear,Protective Device, Hearing,Protective Devices, Ear,Protective Devices, Hearing
D004432 Ear, Middle The space and structures directly internal to the TYMPANIC MEMBRANE and external to the inner ear (LABYRINTH). Its major components include the AUDITORY OSSICLES and the EUSTACHIAN TUBE that connects the cavity of middle ear (tympanic cavity) to the upper part of the throat. Tympanic Cavity,Tympanum,Middle Ear,Cavities, Tympanic,Cavity, Tympanic,Ears, Middle,Middle Ears,Tympanic Cavities,Tympanums
D004487 Edema Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE. Dropsy,Hydrops,Anasarca
D005158 Facial Paralysis Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. FACIAL NERVE DISEASES generally results in generalized hemifacial weakness. NEUROMUSCULAR JUNCTION DISEASES and MUSCULAR DISEASES may also cause facial paralysis or paresis. Facial Palsy,Hemifacial Paralysis,Facial Palsy, Lower Motor Neuron,Facial Palsy, Upper Motor Neuron,Facial Paralysis, Central,Facial Paralysis, Peripheral,Facial Paresis,Lower Motor Neuron Facial Palsy,Upper Motor Neuron Facial Palsy,Central Facial Paralyses,Central Facial Paralysis,Facial Palsies,Facial Paralyses, Central,Facial Paralyses, Peripheral,Palsies, Facial,Palsy, Facial,Paralyses, Central Facial,Paralyses, Facial,Paralyses, Hemifacial,Paralysis, Central Facial,Paralysis, Facial,Paralysis, Hemifacial,Paralysis, Peripheral Facial,Pareses, Facial,Paresis, Facial,Peripheral Facial Paralysis

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