How to determine the prognosis of facial palsy?

  Facial palsy with damage to the geniculate ganglion (D), facial palsy of the stapedial nerve segment (C), facial palsy of the bulbar nerve segment (B), and facial palsy at the stem mammary foramen (A).  The relationship between the site of facial palsy damage and prognosis: for those with damage in segment A, the prognosis was significantly higher than that of those with poor prognosis; for those with damage in segments C and D, the prognosis was significantly higher than that of those with good prognosis, and there was a highly significant difference between the two.  2. The relationship between the number of combined symptoms of facial palsy (loss of taste, auditory hypersensitivity, tear reduction and vertigo) and prognosis: those who combined <2 of the above-mentioned manifestations had a significantly higher prognosis than those with a poor prognosis; those who combined >2 had a significantly higher prognosis than those with a good prognosis. In both cases, there was a highly significant difference.  The relationship between the size of the lid fissure on the side of facial palsy and prognosis: those with a lid fissure of <6 mm had a significantly higher prognosis than those with a poor prognosis; those with a lid fissure of >6 mm had a significantly higher prognosis than those with a good prognosis.  4. The relationship between the classification of facial palsy and prognosis: in cases with wind-cold obstruction (thin white coating), the prognosis was significantly higher than that of poor prognosis; in cases with wind-heat obstruction (thin yellow coating), the prognosis was not significantly different from that of poor prognosis; in cases with stasis-blood obstruction (after trauma and surgery, purple tongue or petechiae), the prognosis was poor.  5. Multifactorial: The degree of correlation is, in descending order, the size of the lid fissure, the number of combined symptoms, and the identification and typing. Patient age, significant pain behind the ear, and recurrence of facial palsy were not significantly correlated with prognosis.  In conclusion, those with facial palsy only with damage to the facial nerve below the bulbar cord had the lowest site and the best prognosis; those with damage to the superficial greater nerve and above with combined tear reduction, or ear herpes or vertigo had the highest site and the worst prognosis. If the facial palsy is combined with two or less of these manifestations, the facial nerve damage is small and the prognosis is good; if two or more, the damage is large and the prognosis is poor.  The branch of the facial nerve that exits the mastoid foramen innervates the movement of the orbicularis oculi muscle, and the damage is associated with incomplete eyelid closure. Studies have shown that the size of the lid fissure on the side of facial palsy is the most important indication of the degree of facial nerve damage and has the greatest prognostic correlation. The larger the lid fissure, the more severe the orbicularis oculi paralysis, the more severe the facial nerve damage, and the worse the prognosis. Therefore, observation of the size of the lid fissure on the side of facial palsy is a convenient and reliable indicator for predicting prognosis.  In the case of wind-cold obstruction of facial palsy, there are no obvious heat signs, and the facial nerve inflammation may not be serious, so the prognosis is good; in the case of wind-heat obstruction, there are heat signs with yellow moss, and the facial nerve inflammation may be obvious, so the prognosis is not as good as that of wind-cold obstruction; in the case of stasis-blood obstruction, the prognosis is the worst because of trauma or surgery, resulting in serious damage to the facial nerve.