Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell's Palsy

Turk Arch Otorhinolaryngol. 2022 Jun;60(2):80-87. doi: 10.4274/tao.2022.2022-2-14. Epub 2022 Aug 31.

Abstract

Objective: To investigate the prognostic value of the magnetic resonance imaging in Bell's palsy patients.

Methods: Patients who were diagnosed and treated with Bell's palsy between October 2013 and March 2016 retrospectively selected. House-Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell's palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.

Results: No significant correlation was observed between pretreatment House-Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell's palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.

Conclusion: The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell's palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell's palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression.

Keywords: Bell’s palsy; acoustic reflex; facial nerve; gadolinium DTPA; magnetic resonance imaging; prognosis; radiology; temporal bone.