Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Aug 3;35(30):e245.
doi: 10.3346/jkms.2020.35.e245.

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

Su Jin Kim  1 , Ho Yun Lee  2
Affiliations
Meta-Analysis

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

Su Jin Kim et al. J Korean Med Sci. .

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.

Keywords: Facial Palsy; Guidelines; Meta-analysis; Systematic Review.

PubMed Disclaimer

Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
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.
See this image and copyright information in PMC

References

    1. Song K, Chang S, Lee J, Shin SA, Lee HY. Clinical characteristics of dizziness associated with acute peripheral facial palsy. J Audiol Otol. 2018;22(3):148–153. - PMC - PubMed
    1. Lee HY, Kim MG, Park DC, Park MS, Byun JY, Yeo SG. Zoster sine herpete causing facial palsy. Am J Otolaryngol. 2012;33(5):565–571. - PubMed
    1. Chang DS, Lee J, Shin SA, Lee HY. Characteristics of patients with acute peripheral facial palsy showing Varicella zoster virus DNA in saliva. J Med Virol. 2018;90(5):959–964. - PubMed
    1. 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):1972–1983. - PubMed
    1. Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical practice guideline: Bell's Palsy executive summary. Otolaryngol Head Neck Surg. 2013;149(5):656–663. - PubMed