Is Bell's palsy a bilateral condition? A temporal magnetic resonance image analysis of contrast enhancement across all segments of the facial nerve.

Authors

Egemen Cengiz, Emel Tahir, Aslı Tanrıvermiş Sayıt, Özgür Kemal, Sinan Atmaca

Published in

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. Jul 27, 2026. Epub Jul 27, 2026.

Abstract

To determine the contrast enhancement values in the facial nerve segments using magnetic resonance imaging (MRI) and to examine the association with clinical progress in Bell's palsy.
Temporal MRI images of 90 adult patients with Bell's palsy and 45 individuals without facial nerve pathology (control group) were analyzed retrospectively. Each of the five intratemporal segments of the facial nerve was delineated bilaterally, and quantitative values obtained using point-shaped ROI (region of interest) were recorded. These values were compared between the affected and unaffected sides of Bell's palsy patients, as well as between the unaffected side and the control group. The association between the disease's progress was examined.
The ROI value of the affected side of the patients was significantly greater than the normal side in all segments. Contrast measures in five separate patient segments could not predict improvement after three months. At the end of the 6th month, ROI values could not predict whether the patient would have progression or not. In all 5 segments, ROI intensity values were found to be significantly higher in the unaffected sides of patients than in the ears of healthy individuals in the control group.
The mean ROI intensity value in any segment of the facial nerve on the affected side could not predict the prognosis of patients with Bell's palsy. The considerable rise in signal intensity values evaluated by point-shaped ROI may suggest a possible role for systemic and local immunological responses; however, this interpretation remains a hypothesis, as no direct laboratory immunological evidence was obtained in the present study.

PMID:
42507203
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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