贝尔面瘫是否需采取手术治疗,至今尚有争议。作者主张有选择地为本病患者进行面神经减压术。术中应用诱发肌电描记法证实94％的患者病变在面神经管内并位于耳道孔(meatal foramen,位于内耳道底)处,该处有纤维韧带的约束,成为整个面神经管中最细的一段。当面神经因病变而水肿时,耳道孔处神经纤维最易受压,并致内耳道段神经的明显肿胀。因此通过去除骨质,切开神经鞘膜,对面神经进行减压,将有利于面瘫的恢复。经神经元电检查法测定,证明发生面瘫后3周内,若面神经变性少于90％时,不经治疗,面神经功能也多能自行恢复,但若在起病后2周内神经变性达95～100％时,仅有50％患者能恢复功能。因此作者建议,在发生贝尔氏面瘴后2周内,如神经变化已达90％时,宜即行手 Bell facial paralysis is required to take surgery, is still controversial. The authors advocate selective facial nerve decompression for patients with this disease. Intraoperative use of electromyography confirmed 94% of patients with lesions in the facial nerve canal and located in the ear canal hole (meatal foramen, located at the end of the ear canal), where the fibrinolytic constraints, as the entire facial nerve tube in the thinnest section . When the facial nerve due to disease and edema, the ear canal nerve fibers most vulnerable to compression, and caused obvious swelling of the nerves within the canal segment. Therefore, by removing the bone, cut the nerve sheath, the facial nerve decompression, will be conducive to the recovery of facial paralysis. Neuroendocrine examination confirmed that within 3 weeks after facial paralysis, if facial degeneration less than 90%, without treatment, facial nerve function and more able to self-recovery, but if within 2 weeks after onset neurodegeneration 95 ~ 100%, only 50% of patients can restore function. Therefore, the author suggests that within 2 weeks after Belleville’s noodles, such as nerve changes have reached 90%, it is advisable