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When you’re diagnosed with Bell’s Palsy, if it’s among the more severe types of Bell’s Palsy, you will undergo electrophysiologic testing. This means that you’re sent to an otologist or a neurotologist (which is an ear, nose, and throat trained doctor), along with a physiologist or a neurophysiologist and they will measure the electrical stimulation of your face. If you meet certain criteria and you’re severely debilitated from this, instead of undergoing the regular treatment with corticosteroids, you will undergo decompression surgery. This is very, very rare. It’s extremely rare, but sometimes it’s necessary. If you’re one of those few people who has very, very poor stimulation and it’s one that is not going to recover, they send you for decompression surgery. Decompression surgery means that you go to the narrowest point of the canal that the facial nerve goes through, you drill away the bone so that this nerve (instead of being compressed and inflamed in one small area) can now expand and receive its proper blood supply. If it’s compressed into this narrow canal that it’s normally born in, the blood supply is constricted and the nerve can die in that area. What later follows, which is called wallerian degeneration (and regeneration, for that matter) afterwards is so severe that the nerve never grows back. This is why decompression surgery is performed.
