1. Clinical Bottom Line: Based on our evaluation of current literature, factoring in statistical evidence as well as strength of study design and timeframe of intervention, we conclude that there are a few valid options for patients with Bell’s palsy. Mime therapy, electrical stimulation, and neuromuscular reeducation with biofeedback are all appropriate interventions for patients who suffer from chronic symptoms of Bell’s palsy to increase facial function. The more invasive surgical interventions including fascial sling placement or reanimation procedures may be appropriate for specific patients with long-standing chronic impairments who are educated and willing to undergo the risks of surgery. Acupuncture may also prove to be effective for some patients in the more acute phase. Biofeedback demonstrates inconclusive evidence supporting its efficacy in the acute population, but due to trends of decreased synkinesis it remains a potential treatment option. We would not recommend corticosteroids for patients with Bell’s palsy, as evidence does not favor its use over other treatments or no treatment at all. Currently, more studies including the randomization of subjects, control groups, and assessor blinding are needed to more clearly evaluate the efficacy of the various available treatments for Bell’s palsy. With stronger studies, and more conclusive findings, we could then determine the most effective timeframe for intervention, frequency and duration of intervention, as well as the most effective way to treat Bell’s palsy.
2. Clinical Scenario: Bell’s palsy is the most prevalent of all of the facial palsies. The physiological effects impact the emotional aspect of conveying emotion and relating to others through non-verbal expression in addition to affecting the functional tasks of eating, drinking, closing the eyes. The widespread effects of this disorder and the psychosocial ramifications make effective treatment for Bell’s palsy in high demand. We would like to evaluate the different treatment options for patients with Bell’s palsy in order to determine the effectiveness of those available interventions.
3. Our clinically answerable question: Population: Patients with Bell’s palsy Intervention: Treatment techniques or programs that improve signs of Bell’s palsy and restore facial function Comparison: A control group, or a group of differing treatment interventions Outcomes: Reduction of synkinesis, increase of voluntary facial movement, increase of symmetry
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