Abstract
Objective
To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults.
Methods
Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.
Results
The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve.
Conclusions
Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy.
Keywords
Facial palsy; Facial paralysis; Bell palsy; Facial nerve disease; Herpes Zoster Oticus; Facial nerve trauma; Microvascular decompression surgery; Guidelines
Highlights
This is an evidence-based review on the recommendations for the diagnosis and treatment of Peripheral Facial Palsy (PFP).
The diagnosis of PFP is based on epidemiological data, medical history, and physical examination.
As the nerve regenerate, neural desynchronization and muscle depolarization occurs at different intervals.
Surgical decompression of the facial nerve is suggested when electrophysiologic testing shows degeneration greater than 90%.