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[Facial paralysis: 40 years of clinical experience].

Over the last 40 years, peripheral facial palsy has been the centre of our attention. Of the 322 patients operated, 69% had a post-traumatic palsy and 31% a non-traumatic palsy. Among the latter, Bell's palsy was the most frequent, affecting over 71 patients. Its etiopathology, reinforcing a concept put forward over 20 years ago as to possibility of an initial vasodilatation with a latter ischemic anoxia of stasis depending on local conditions, explains the variety of surgical discoveries. The seat of the largest compression may be encountered both in the supragenicular and infragenicular portion. In addition to the decmpression of the mastoid and tympanic portions of the facial nerve, since 1972 we have been implementing a transattical decompression of the geniculate ganglion.