Can temporal bone magnetic resonance imaging estimate the prognosis of idiopathic facial palsy?

Background: In facial palsy patients, electroneuronography (ENoG) was used for the diagnosis of the prognosis of facial palsy. This study aimed to determine whether temporal bone magnetic reso-nance imaging (TBMR) was useful for diagnosing and predicting prognosis in facial palsy. Materials and Methods: Among the patients diagnosed with facial palsy, 112 patients who underwent TBMR were included. These patients were divided into three groups according to the enhancement region of the facial nerve in TBMR. Fifty-five patients showed contrast enhancement in the meatal or labyrinthine segment (group 1), 36 patients showed enhancement in the geniculate ganglion (group 2), and 21 patients showed enhancement in the tympanic or mastoid segment (group 3). The initial facial palsy symptoms and prognosis were compared between the three groups. Results: In group 1, 26 patients showed House-Brackmann grade (H-B grade) IV, V initially, and 13 patients and 12 patients showed H-B grade IV, V initially in group 2 and group 3, respectively. Moreover, the initial ENoG results (%) between the three groups did not significantly differ. Patients who took more than 6 months to recover after systemic steroid therapy were 5 patients in group 1, 3 patients in group 2, and 2 patients in group 3. Conclusions: In TBMR of the patients with facial nerve palsy, the most contrast enhancement parts of the facial nerve were the meatal and labyrinthine segments. Enhancement of those segments showed severe initial symptoms clinically. In addition, most of them recovered within 6 months. However, there was no statistical significance, so further studies are needed for more cases and ob-servation periods.