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Computed tomographic features of the proximal petrous facial nerve canal in recurrent Bell's palsy

Research output: Contribution to journalArticlepeer-review

Philip Touska, Cristina Dudau, Janki Patel, Antanas Montvila, Milda Pucetaite, Rupert Obholzer, Irumee Pai, Steve Connor

Original languageEnglish
Pages (from-to)816-823
Number of pages8
JournalLaryngoscope investigative otolaryngology
Volume6
Issue number4
Early online date9 Jun 2021
DOIs
Accepted/In press9 Jun 2021
E-pub ahead of print9 Jun 2021
Published6 Sep 2021

Bibliographical note

Funding Information: We gratefully acknowledge the work of Dr Melisha Pinto for her work in helping compile the study database. Publisher Copyright: © 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Objectives
The primary objective was to determine whether the narrowest dimensions of the labyrinthine facial nerve (LFN) canal on the symptomatic side in patients with unilateral recurrent Bell's palsy (BP) differ from those on the contralateral side or in asymptomatic, age- and gender-matched controls on computed tomography (CT). The secondary objectives were to assess the extent of bony covering at the geniculate ganglion and to record inter-observer reliability of the CT measurements.

Methods
The dimensions of the LFN canal at its narrowest point perpendicular to the long axis and the extent of bony covering at the geniculate ganglion were assessed by two radiologists. Statistical analysis was performed using the Wilcoxon signed-rank and Mann-Whitney U tests (LFN canal dimensions) and the Chi-squared test (bony covering at the geniculate ganglion). Inter-observer reliability was evaluated using Intra-Class Correlation (ICC) and Cohen's kappa.

Results
The study included 21 patients with unilateral recurrent BP and 21 asymptomatic controls. There was no significant difference in the narrowest dimensions of the ipsilateral LFN canal when compared to the contralateral side or controls (P = .43-.94). Similarly, there was no significant difference in the extent of bony covering at the geniculate ganglion when compared to either group (P = .19-.8). Good inter-observer reliability was observed for LFN measurements (ICC = 0.75-0.88) but not for the bony covering at the geniculate ganglion (Cohen's kappa = 0.53).

Conclusion
The narrowest dimensions of the LFN canal and the extent of bony covering at the geniculate ganglion do not differ in unilateral recurrent BP, casting doubt over their etiological significance.

Level of Evidence
Level IV.

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