If the nerve cannot be spared at the time of resection, interpositional grafting is warranted. Unfortunately, this leads to over-diagnosis of the condition and a false sense of security. Every patient with a facial paralysis needs a complete evaluation. Failure of any return of function implies an etiology other than Bell's palsy. Re-evaluation is mandatory in such cases, as the most commonly overlooked diagnosis is one of neoplasia.
Etiology is still unknown.
Electrical testing follows the degeneration of the motor fibers. Steroids are indicated early in the course of the disease. The use of acyclovir is under investigation. Surgical decompression is accomplished via the middle fossa by an otologist-neurotologist. Transmastoid decompression is no more efficacious than steroid therapy.