Abstract:

Objective    To recognize the correlation of segment of lesion and prognosis in the patients with peripheral facial palsy by Gd-enhanced MRI. Methods    The patients were scanned by Siemens Magnet V1.5 T, while contralateral as control. The conventional T1WI, T2WI axial and coronal thin layer scanning, Gd-DTPA-enhanced, delayed 30min re-imaging and multi-plane reconstruction were performed. Results     ① In 3 patients who underwent operation, 1 displayed in reconstruction full-distance normal nerve without interruption and edema. She recovered completely to the H-B 1 grading in 3 months. Another patient had facial palsy before the operation due to huge cholesteatoma.  Entire facial nerve showed edema but no discontinuity.  The patient recovered to H-B 3 grading after the operation. MRI reconstruction of the last huge vestibular schwannoma patient demonstrated facial nerve continuous as same as before the operation. H-B grading remained at 6 before and after the operation. ② Among six Bell′s palsy patients, enhancement were noted from inner ear to tympanic segment in one case, inner ear to labyrinth segment in one case, geniculate ganglion and tympanic segment in one case,  geniculate ganglion to mastoid segment in two cases, and only inner ear segment in two cases. All six patients were cured after the treatment with H-B grading 1. ③ Among six Ramsay Hunt syndrome patients, facial nerves showed normal in one case and enhancement in inner ear segment in two cases. Of the 3 remaining cases, 2 showed enhancement in inner ear segment, while 1 in mastoid segment. After the treatment, 5 patients showed enhancement in cochlea, but all six recovered to H-B grading 1. Conclusion    MRI enhancement and reconstruction can clearly reveal segment and extent of facial nerve lesion, in addition to prognostic information.

Key words: Facial palsy, peripheral, Facial nerve; , Prognosis, Magnetic resonance imaging