Task force of the Brazilian Society of Otology — evaluation and management of peripheral facial palsy

• Published in: Brazilian journal of otorhinolaryngology Vol. 90; no. 3; p. 101374
• Main Authors: Pauna, Henrique Furlan, Silva, Vagner Antonio Rodrigues, Lavinsky, Joel, Hyppolito, Miguel Angelo, Vianna, Melissa Ferreira, Gouveia, Mariana de Carvalho Leal, Monsanto, Rafael da Costa, Polanski, José Fernando, Silva, Maurício Noschang Lopes da, Soares, Vítor Yamashiro Rocha, Sampaio, André Luiz Lopes, Zanini, Raul Vitor Rossi, Abrahão, Nicolau M., Guimarães, Guilherme Correa, Chone, Carlos Takahiro, Castilho, Arthur Menino
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España S.L.U 01.05.2024; Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial; Elsevier
• Subjects: Adult; Advisory Committees; Bell palsy; Brazil; Child; Evidence-Based Medicine; Facial nerve disease; Facial nerve trauma; Facial palsy; Facial paralysis; Facial Paralysis - etiology; Facial Paralysis - physiopathology; Facial Paralysis - therapy; Guidelines; Herpes Zoster Oticus; Humans; Microvascular decompression surgery; OTORHINOLARYNGOLOGY; Societies, Medical; Brazil; Facial palsy; Microvascular decompression surgery; Bell palsy; Herpes Zoster Oticus; Facial paralysis; Facial nerve trauma; Facial nerve disease; Guidelines
• ISSN: 1808-8694; 1808-8686; 1808-8686
• DOI: 10.1016/j.bjorl.2023.101374

•This is an evidence-based review on the recommendations for the diagnosis and treatment of Peripheral Facial Palsy (PFP).•The diagnosis of PFP is based on epidemiological data, medical history, and physical examination.•As the nerve regenerate, neural desynchronization and muscle depolarization occurs at different intervals.•Surgical decompression of the facial nerve is suggested when electrophysiologic testing shows degeneration greater than 90%. To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy.