Bell's palsy Podcast: Medical and Surgical Management
This podcast highlights a Clinical Practice Guideline on Bell’s Palsy appearing as a November 2013 supplement in Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief Richard Rosenfeld is joined by authors Lisa Ishii, assistant chair of the guideline development group, and Richard Gurgel, a neurotologist, in discussing aspects of the guideline related to medical and surgical management.
Description
The myriad of treatment options for Bell’s palsy include medical therapy (steroids and antivirals, alone and in combination), surgical decompression of the facial nerve, and complementary and alternative therapies such as acupuncture. Based on systematic review of the best available evidence, plus an explicit consideration of benefits and harms, the guideline development group made a strong recommendation that clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell’s palsy patients 16 years and older. Oral antiviral therapy may be offered in addition to oral steroids, but a strong recommendation was made against prescribing oral antiviral therapy alone because efficacy has not been established. Suggested dosing regimens and patient selection are discussed further in the podcast. Although acupuncture, surgical decompression, and physical therapy are used in managing Bell’s palsy patients, the existing evidence was of insufficient, quality, quantity, or consistency to permit any recommendation to be made for or against their use.
