Etiology and Management of 800 Patients With Facial Palsy at a Private Practice Setting Over a 5-Year Period

Author:

Melhem Antonio M.123,Leshgold Nicole4,Pokress Henry5,Younan Robert A.16,Haddad Mario178,Kantar Rami S.19,Azizzadeh Babak11011

Affiliation:

1. Global Smile Foundation, Norwood, MA

2. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA

3. Department of Surgery, Wyckoff Heights Medical Center, Brooklyn

4. Department of Global Health, University of Washington, Seattle, WA

5. Department of Biology, Harvard-Westlake School

6. Department of Plastics Surgery, Augusta University Medical Center, Augusta, GA

7. Department of Plastics & Reconstructive Surgery, University of California-Irvine, Irvine, CA

8. Department of Plastics Surgery, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ

9. The Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York City, NY

10. Department of Plastics Surgery, Cedars-Sinai Health System

11. Department of Plastics Surgery, David Geffen School of Medicine, UCLA, Los Angeles

Abstract

Introduction: Very few papers investigated the etiologic breakdown and demographic characteristics of patients with facial nerve (FN) palsy. Our paper aims to present the etiologic breakdown and demographic characteristics of patients with FN palsy, presenting at a private care center between 2014 and 2019, along with the treatment modalities that were offered to them. Methods: Charts of 800 patients with facial palsy (FP) were reviewed. Data included the etiology of their diagnosis, family history, recurrent FP, demographic information, and treatment provided before and after presentation. Results: Seventy-five percent of our study population were females. The average period between diagnosis with FP and presentation at our center was 10.8 years. The most commonly identified etiology was Bell’s palsy, followed by acoustic neuroma. Eighty-one percent of the study subjects were prescribed steroids and/or antivirals. Facial neuromuscular retraining, electrical stimulation, chemodenervation, and surgical intervention were also part of some treatment plans for our population. Discussion: Recommendations for the treatment of idiopathic FP include steroids with adjuvant antiviral medications. Data remains uncertain whether the combination therapy of steroids and antivirals has better results compared to steroids alone. Electrical stimulation is still a controversial therapeutic tool for facial paralysis with a potential role in exacerbating synkinesis. The difference in referral patterns between tertiary and private care centers can explain the disparity in the ranking of the etiologies between our study and what has been published. Conclusion: Management of FP is a complex process. The FN community must develop a common database to improve its understanding of the different presentations.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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