Clinical Practice Guideline: Bell's Palsy

Abstract

Program Description: This miniseminar will consist of a lively panel discussion on the evidence-based recommendations for the treatment and management of Bell’s palsy as outlined in the recently published AAO-HNS Clinical Practice Guideline. The guideline seeks to improve the quality of and reduce variation in the care Bell’s palsy patients receive. The panel will present the key action statements that address patient presentation, history, and physical examination; laboratory testing; electrodiagnostic testing; diagnostic imaging; surgical decompression; oral steroids and antiviral therapy; and patient follow-up. Case studies will also be presented to illustrate the application of the evidence-based recommendations in clinical practice. Educational Objectives: 1) Decrease harmful variation in care for Bell’s palsy patients. 2) Improve the quality of care and outcomes for Bell’s palsy patients. 3) Practice accurate and efficient diagnosis of Bell’s palsy, and when applicable, increase the use of appropriate counseling and rehabilitative options for patients.

Evaluation of the vascular contacts of the facial nerve on three-dimensional fast imaging employing steady-state acquisition MRI in Bell's palsy

“…[1] Although the precise cause remains unclear, numerous etiologies have been proposed, such as ischemic neuropathy, autoimmune diseases and viral inflammation of the facial nerve. [6,7] The most commonly accepted etiology, however, is HSV-1 infection that induces edema within the facial nerve as an inflammatory response.…”

“…[8] Some risk factors for the development of BP have been identified, including pregnancy, severe preeclampsia, diabetes, hypertension, obesity, and upper respiratory tract infections. [1,9] On the other hand, HSV-1 infection is relatively common in comparison to BP, thus, the presence of contributing factors such as vascular contacts along the course of the facial nerve is a factor to explain why some patients develop palsy and others do not.…”

“…[13,[15][16][17] Furthermore, clinicians are discouraged from routinely performing diagnostic imaging for patients with new onset Bell's palsy. [1] On the other hand, 3D-FIES-TA MRI provides much higher spatial resolution than rou-…”

“…While most patients with Bell's palsy show complete recovery within 3 to 4 months, 30% of patients do not recover completely and have poor outcomes. [1] These patients may experience dramatic effects of the facial palsy on their appearance, quality of life and psychological status. Thus, we may assume that 3D-FIESTA MRI may be valuable in predicting the prognosis in patients with Bell's palsy, particularly in those with recurrent disease and/or progression in HB grades during follow-up.…”

The Effects of Methylprednisolone and Vitamin A on the Healing of Traumatic Peripheral Nerve Paralysis

“…However, incomplete recovery and/or healing with sequelae is also assumed in this ratio. The management of patients who do not respond to treatment still continues as a controversial issue [1] . Steroids, the most commonly used drugs in the treatment of idiopathic facial nerve paralysis (IFNP), have become the classic treatment method due to the anti-inflammatory and anti-edematous effects.…”