Abstract
Aim of the study. The goal of the study was to assess the frequency of
malignancies hidden under the diagnosis of “Bell’s palsy”. We aimed to
create diagnostic algorithm to avoid failures concerning patients whose
only symptom of parotid gland cancer was irreversible FNP. Materials and
methods. We analyzed 253 consecutive patients with FNP treated in our
department in the last 5 years. All patients with irreversible FNP were
reassessed in 6-12 months. We underlined all shortcomings in the
diagnostics of those in whom malignancies were found out in MRI of the
neck and presented the proposal of diagnostic algorithm to avoid missing
such an entity. Results. Bell’s palsy was observed in 157 / 253 patients
(62.06%), in 36 / 157 (22.92%) it remained permanent. In 4 / 36
patients (11.11%) with irreversible FNP, which constituted 2.54% of
all “Bell’s palsy” cases, parotid gland deep lobe mass was found out
in MRI. In one patient infiltration of the skull base was diagnosed.
Adenoid cystic carcinoma was confirmed in final histopathology in all
cases. Conclusions. Our experience has shown that irreversible FNP can
be a revelator of the malignant tumor located in the deep lobe of the
parotid gland. Contrast-enhanced MRI covering intra- and extracranial
segments of facial nerve should be ordered in all cases of FNP without
recovery after 4 months. The main point of our study is to underline
that the assessment of the deep lobe of the parotid gland with MRI
should be included in the standard diagnostic protocol in all
irreversible “Bell’s palsy” cases. Key words: Bell’s palsy, facial
nerve palsy, parotid gland cancer