Facial palsy is serious not because it endangers the patient directly but because, the face being "the mirror of the soul," the afflicted creature loses what Duel1 so aptly named "the language of facial expression." That this may have far reaching psychic, social and economic consequences needs no explanation.
It is therefore understandable that in the past many attempts have been made by many different routes to come to the aid of patients with facial paralysis, but only the intratemporal surgical approach to the facial nerve seems to have brought the surgeon near the goal. Chief credit for this treatment must be given to the Englishman Sir Charles Ballance and the American Dr. Arthur B. Duel, who by their comprehensive animal experiments and subsequent operations on human beings have created the foundation on which present day surgeons build.
The results achieved by Ballance and Duel2 and later by a whole
KETTEL K. FACIAL PALSY OF OTITIC ORIGINWITH SPECIAL REGARD TO ITS PROGNOSIS UNDER CONSERVATIVE TREATMENT AND THE POSSIBILITIES OF IMPROVING RESULTS BY ACTIVE SURGICAL INTERVENTIONAN ACCOUNT OF 264 CASES SUBJECTED TO REEXAMINATION. Arch Otolaryngol. 1943;37(3):303–348. doi:10.1001/archotol.1943.00670030313001
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