Bell's Palsy treatment algorithm
return to: Otology - Neurotology
In patients with Bell's Palsy (facial weakness), return to normal facial nerve function (HB I) occurred in the following % of patients:
- Those treated with Prednisone/Acyclovir: 93% of patients
- Those treated with placebo: 80% of patients
NOTE: Acyclovir did not increase chances of facial nerve recovery
(Sullivan, FM. et. al, N Engl J Med. 2007 Oct 18;357(16):1598-607)
In patients with NO PERCEPTIBLE movement within 14 days of onset:
If ENOG degeneration is <90%, ALL patients returned to HB I or II at 7 months (treated with high dose prednisone)
If ENOG degeneration is >90%, and no voluntary EMG response the facial nerve function outcomes at 7 months were:
without MCF facial nerve decompression: 58% developed poor outcome (HB III or IV); None returned to HB I
WITH MCF facial nerve decompression: 91% returned to normal or near normal (HB I or II)
References:
Gantz, B, Rubinstein, JT, Gidley, P, Woodworth, GG. Surgical management of Bell's palsy. Laryngoscope 1999;109:1177--88
Rodenez C, Bernat I, Willer JC, Barre P, Lamas G and Tankere F: J Laryngol otol. 2010 Mar; 124(3):272-8