J Korean Med Sci.  2020 Aug;35(30):e245. 10.3346/jkms.2020.35.e245.

Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

• Kim SJ
• Lee HY

• KMID: 2505190
• DOI: http://doi.org/10.3346/jkms.2020.35.e245

Abstract

Background
This study reviews recent literature on facial palsy guidelines and provides systematic reviews on related topics of interest.
Methods
An electronic database search was performed to identify recent guidelines dealing with facial nerve palsy, systematic reviews and recent meta-analysis published between 2011 and 2019 (inclusive). The literature search used the search terms “Bell's palsy,” “Ramsay-Hunt syndrome,” “Facial palsy,” “Facial paralysis,” “Facial paresis,” “Guideline,” “Meta-analysis,” “Systematic review,” and “Randomized controlled trial.” Only studies written in English were used.
Results
The characteristics of treatment trends for facial palsy have been reviewed over the past decade. The most prominent change noted may be the shift from the conventional House-Brackmann facial nerve grading system to the Sunnybrook and eFACE systems. In addition, the results of serial meta-analyses indicate increasing agreement with the use of surgical decompression of the facial nerve. Beyond steroids or combined steroid-antiviral treatment, various novel drugs and treatments have been tried. For long-standing facial paralysis and postparetic synkinesis sequelae after facial palsy, facial reanimation has been highlighted and the necessity of new paradigms have been raised.
Conclusion
For peripheral facial paralysis, various changes have been made, not only in the facial nerve grading systems, but also in medical treatments, from surgical procedures to rehabilitation, during the last decade.

Keyword

Facial Palsy; Guidelines; Meta-analysis; Systematic Review

Figure

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  Fig. 1 Research parameters. An electronic database search was performed to retrieve facial nerve guidelines and recent randomized trials until 28th February 2020. One guideline (please refer to [4]: Rath B, Gidudu JF, Anyoti H, Bollweg B, Caubel P, Chen YH, et al. Facial nerve palsy including Bell's palsy: Case definitions and guidelines for collection, analysis, and presentation of immunisation safety data. Vaccine 2017;35(15):1972-83.) was excluded on the basis of our exclusion criteria, because this was not intended to target the practical management of peripheral facial palsy, but rather reporting methods.

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