Medical and surgical management of facial nerve palsy.
OBJECTIVE
To review the results of recently published studies on the medical management of Bell's palsy and highlight strategies in the surgical management of facial nerve palsy.


RESULTS
Although corticosteroid and antiviral therapy have been proposed for the treatment of Bell's palsy for many years, the clinical efficacy of these treatments has been debated in the literature due to the lack of conclusive evidence from large-scale clinical trials. However, recently completed randomized, controlled studies have found that the early administration of corticosteroids improves the chances of full recovery in patients with Bell's palsy. But there remains insufficient evidence supporting the routine use of antiviral medications in the treatment of Bell's palsy. In addition, improvement in surgical techniques has allowed the introduction of a number of surgical procedures for patients with permanent facial nerve palsy.


CONCLUSIONS
On the basis of the results of several recently completed randomized, controlled studies, corticosteroid therapy has proven to be efficacious in the treatment of Bell's palsy and should be offered to patients presenting within 72 h of symptom onset with consideration to the addition of antiviral therapy for severe cases. Currently available surgical procedures can minimize the complications associated with permanent facial nerve palsy.
Hazin
Ribhi
R
Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts, USA.
Azizzadeh
Babak
B
Bhatti
M Tariq
MT
D000998:Antiviral Agents / Q000627:therapeutic use; D020330:Bell Palsy / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000503:physiopathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D009801:Oculomotor Muscles / Q000294:innervation; D013508:Ophthalmologic Surgical Procedures; D016896:Treatment Outcome
D000998:Antiviral Agents; D005938:Glucocorticoids