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Evaluation of the early phase of Bell’s palsy using 3 T MRI

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Abstract

This prospective study on Bell’s palsy investigated the value of 3 T MRI as a diagnostic tool to evaluate pathophysiological changes (i.e. edema) of facial nerve segments and the possibility to differentiate patients with high risk for incomplete recovery from patients who recover completely within 3 days after symptoms onset. For this institutional review board approved investigation, thirty patients (14 male, 16 female, mean age 44 years) with Bell’s palsy underwent pre and postcontrast 3 T MRI of the cerebellopontine angle. T1-weighted imaging was performed (TR 20.0 ms, TE 2.46 ms, isotropic voxel size: 0.6 mm). Region-of-interest measurements were performed on the healthy and paralyzed side. To obtain normalized values, signal intensity increase percentage (SIIP) values were divided by contralateral results of the healthy side. Signal intensity measurements of examined nerve segments were compared using Wilcoxon and Mann–Whitney U tests and correlated to clinical findings categorized by the House–Brackmann score. The lesion side showed significantly higher signal intensities in the premeatal segment before and after contrast agent administration (P < 0.001). SIIP was highest in the premeatal segment compared to the geniculate ganglion (P < 0.001). Correlation analyses revealed no association between signal intensity measurements, clinical findings or early recovery rates after 3 months (P > 0.05). According to our results, early palsy-associated pathophysiological changes in the facial nerve premeatal segment might also be related to accumulation of proteins and not exclusively to edema. However, contrast agent enhancement quantification was not suitable as a diagnostic tool to distinguish different prognostic groups.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital-Friedrich Schiller University Jena, Philosophenweg 3, 07740, Jena, Germany

    Hartmut Peter Burmeister, Pascal Andreas Thomas Baltzer, Anke Kraft, Matthias Dietzel & Werner Alois Kaiser

  2. Department of Otorhinolaryngology, University Hospital-Friedrich Schiller University Jena, Lessingstraße 2, 07743, Jena, Germany

    Gerd Fabian Volk & Orlando Guntinas-Lichius

  3. Department of Neurology, University Hospital-Friedrich Schiller University Jena, Erlanger Allee 101, 07747, Jena, Germany

    Carsten Michael Klingner & Otto Wilhelm Witte

  4. Department of Radiology at Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

    Werner Alois Kaiser

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  1. Hartmut Peter Burmeister
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  2. Pascal Andreas Thomas Baltzer
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  3. Gerd Fabian Volk
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  4. Carsten Michael Klingner
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  9. Orlando Guntinas-Lichius
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Correspondence to Hartmut Peter Burmeister.

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Burmeister, H.P., Baltzer, P.A.T., Volk, G.F. et al. Evaluation of the early phase of Bell’s palsy using 3 T MRI. Eur Arch Otorhinolaryngol 268, 1493–1500 (2011). https://doi.org/10.1007/s00405-011-1498-x

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  • DOI: https://doi.org/10.1007/s00405-011-1498-x

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