Prognosis Of Facial Palsy Research Articles

Global Trends and Performances of Acupuncture Therapy on Bell's Palsy from 2000 to 2023: A Bibliometric Analysis.

Recent studies have shown that acupuncture may have great potential in the treatment of Bell's palsy. However, the bibliometric analysis of this field has not been summarized properly. Thus, the purpose of this study is to analyze the hotspot of acupuncture for Bell's Palsy. The core collection database of Web of Science was searched for relevant publications from 2000 to 2023, and countries, institutions, authors, keywords, and literature were analyzed and visualized by bibliometric softwareCiteSpace 5.1.R6, Vosviewer, BICOMB, and gCLUTO to explore the scientific achievements, research collaboration networks, research hot spots, and research trends. 229 publications were included in this study. The most cited journal is Journal of Otolaryngology-Head & Neck Surgery; the most prolific country is China; the most prolific author is Li Ying, moreover, the collaboration among scholars is poor; Kyung Hee University is the most prolific institution studying acupuncture for Bell's Palsy. Reference burst detection indicates that traditional Chinese Medicine philosophy, the role of acupuncture in the prognosis of facial palsy, mechanism of acupuncture to improve facial nerve function, and the use of electroacupuncture are starting to become new research hotspots. The field of acupuncture for Bell's Palsy has developed rapidly in recent years, and new research trends are mainly: combination with traditional Chinese medicine, the role of acupuncture in the prognosis of facial palsy, mechanism of acupuncture to improve facial nerve function, and the use of electroacupuncture. However, research in this field is still dominated by case reports and clinical trials, and there is a lack of large-scale, multicenter clinical trials and animal experiments there are still many problems in institutional cooperation and experimental design, which requires relevant researchers to strengthen cooperation and improve experimental design.

Clinical Features and Prognosis of Facial Palsy and Hearing Loss in Patients With Ramsay Hunt Syndrome.

Ramsay Hunt syndrome, a late manifestation of varicella-zoster virus infection, occurs when the virus reactivates, infects, and produces an inflammatory reaction in the seventh cranial nerve geniculate ganglion. The detection is made clinically on the basis of the following three features: facial nerve palsy, the presence of characteristic herpetic vesicles around the mouth, and pain in the ear. However, it is often diagnosed quite late and sometimes even missed, increasing the chances of complications that have long-term effects. The two significant complications following the development of Ramsay Hunt syndrome are facial nerve palsy and hearing impairment. Ramsay Hunt syndrome is among the principal causes of facial nerve palsy, implicated in around 2-10% of all cases. While hearing loss though prevalent, is a less common complication than facial palsy. This review aimed to analyze the clinical presentation and prognostic features of the complications of Ramsay Hunt syndrome mentioned above, that is, hearing loss and facial nerve palsy. It was seen that while the association of Ramsay Hunt syndrome with facial nerve palsy has been studied quite extensively, the literature on hearing loss as a sequela is quite lacking. The course and outcome of facial nerve palsy is determined by the early clinical picture, while the otological symptoms rely on the extent of nerve involvement. Early diagnosis and treatment go a long way in preventing these complications and increasing the chances of complete recovery. Treatment options most commonly studied included antiviral drugs such as acyclovir, steroids, and anti-inflammatory agents.

Prognosis prediction changes based on the timing of electroneurography after facial paralysis

Background The process of determining the prognosis and subsequent facial nerve decompression has become an important factor in determining the patient’s quality of life. Aim In this study, the prognosis of facial paralysis was verified in detail based on the timing of electroneurography (ENOG) and nerve conduction study (NCS). Materials and methods The ENOG and NCS of 368 facial palsy patients were analyzed. House–Brackmann (HB) scale after 6 months was used as an outcome. For the ENOG, nasalis muscle/levator labii superioris alaeque nasi (NL), and orbicularis oculi (OO) muscle were used and NCS performed using temporal, zygomatic, and buccal branches. Results ENOG at the OO performed 4–6 d after onset was ≤10% (p = .002, 10.0-fold) and showed unfavorable results (when the standard was ≥30%). In addition, the ENOG at the NL performed 13–15 d after onset was ≤10% (p = .001, 10.5-fold) and showed unfavorable results (when the standard was ≥30%). Conclusions The results indicated that ENOG at the OO performed 4–6 d after onset and ENOG at the NL performed 13–15 d after onset had more prognostic value for the outcomes of acute peripheral facial palsy.

Characteristics of and Prognosis for Facial Palsy in Patients With Otitis Media With ANCA-Associated Vasculitis (OMAAV).

The aim of the present study was to investigate the characteristics and prognosis of facial palsy in patients with otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV). Retrospective case review. Tertiary referral center. Thirty-seven patients with OMAAV. The patients were divided into the facial palsy group and non-palsy group. The severity of and prognosis for facial palsy were evaluated using the House-Brackmann facial grading system (HB). Characteristics were compared between the facial palsy group and non-palsy group. Facial palsy was observed in eight patients. The last HB grade for all patients was either grade I or II after treatment with a combination of corticosteroids and immunosuppressant therapy. There were no cases in which palsy relapsed. Facial palsy in OMAAV was significantly more common in female patients, and patients with facial palsy demonstrated significantly higher rates of hypertrophic pachymeningitis than did those without facial palsy. Facial palsy in patients with OMAAV was detected in 21.6% and a good prognosis was obtained by use of the appropriate treatment. Facial palsy is one of the most important symptoms by which to diagnose OMAAV. When encountering the patients with intractable otitis media complicated with facial palsy, appropriate examination including ANCA titer should be performed.

The Importance of Duration in the Prognosis of Facial Nerve Palsy and Its Treatment-A Case Report

Background: Facial nerve palsy is considered to be one of the most common consequence of untreated chronic suppurative otitis media. The incidence has significantly reduced over the decade due to better imaging technology and use of early antibiotics and better surgical procedures but if left untreated, it has a significant impact over the patient’s day to day life and markedly affects patient’s social life and causes serious psychological damage. An appropriate and prompt management ensures healing of the palsy without sequelae. Case Report: We report a case of bilateral chronic suppurative otitis media with unilateral right grade 4 facial nerve palsy which happened within a duration of 1 month for which patient underwent right modified radical mastoidectomy following which she had steady improvement. Conclusion: This case highlights that in patients with middle-ear cleft cholesteatoma the surgical approaches vary according to duration of palsy and post-operative improvement in facial nerve function can be anticipated in cases of acute palsy. Surgical interventions have been proved to have a good effect in restoration of facial nerve palsy in cases of shorter duration as compared to those of sudden onset and longer duration.

Nystagmus in Ramsay Hunt syndrome with or without dizziness.

The presence of dizziness has been reported as a negative prognostic factor for recovery of facial palsy in Ramsay Hunt syndrome (RHS). The aim of this study was to investigate the incidence and patterns of nystagmus in RHS patients without dizziness, and discuss possible mechanisms. We also compared the severity and prognosis of facial palsy between RHS patients with and without dizziness. From January 2014 to January 2019, 36 patients diagnosed with RHS (27 with dizziness and 9 without dizziness) were included. Patterns of nystagmus were examined and categorized using video-nystagmography. House-Brackmann(HB) grade of facial palsy was compared between RHS patients with and without dizziness. Not only RHS patients with dizziness exhibited nystagmus in most cases (96%, 26 of 27) but also as many as 67% (6 of 9) of RHS patients without dizziness exhibited nystagmus, though the intensity was remarkably weak. In both groups of RHS with and without dizziness, direction-fixed nystagmus and direction-changing positional nystagmus were observed. Initial HB grade and recovery of facial palsy after treatment were not significantly different between RHS with and without dizziness. Various patterns of nystagmus including direction-fixed and positional direction-changing nystagmus were observed in RHS patients, and inflammation of the vestibular nerve and inner ear end organs may be responsible for the production of nystagmus in these patients. The results support that the evaluation of vestibular function may be necessary even in RHS patients who do not complain of dizziness or vertigo.

Investigation Of The Prognostic Value Of The Neutrophil/Lymphocyte Ratio In Bell Palsy

Objectives: Bell palsy (BP), also known as idiopathic facial paralysis, is a unilateral, acute-onset, isolated lower motor neuron weakness. It accounts for 60% to 75% of all cases of unilateral facial paralysis. The estimated annual incidence ranges between 11 and 40 per 100.000 people, with 40.000 new cases each year in different parts of the world. The neutrophil/lymphocyte ratio (NLR), calculated as the ratio of absolute neutrophil count to absolute lymphocyte count, is an easily measurable and inexpensive systemic inflammation marker. This study investigated the association between the NLR and BP by comparing clinical characteristics and functional outcomes of patients with BP and healthy controls. Methods: Thirty patients (24 women, 6 men) who presented to our clinic with BP between 2014 and 2016 were included in the study. The subjects underwent a general physical examination and an assessment of laboratory blood parameters. All patients were treated with prednisone, 1 mg/kg per day with a progressive dose reduction. The NLR was calculated as the simple ratio between absolute neutrophil and absolute lymphocyte counts. Results: The mean (SD) NLR values were 2.141 (0.80) in patients with BP and 1.41 (0.46) in the control group. The difference between groups was significant (p=0.0001). There was a positive correlation between grade of facial paralysis and NLR values (r=0.663, p=0.0001). There was a positive correlation between prognosis of facial paralysis and NLR values (r=0.239, p=0.0251). Conclusion: The NLR was a valuable marker in BP patients in this study. Moreover, this study demonstrated a linear relationship between the NLR and BP severity and prognosis.

Prognostic Factors of Idiopathic Facial Palsy: A Retrospective Study

Objectives : The purpose of this study was to evaluate the clinical prognostic factors affecting facial palsy in 98 idiopathic facial palsy patients who were hospitalized and treated in 2015, using retrospective statistical analysis. Methods : We investigated patients with idiopathic facial nerve palsy, admitted to a Korean medical hospital in 2015, and examined patients` variables and therapeutic variables. For analysis of clinical data, an independent sample t-test, analysis of variance (ANOVA), and simple regression analysis were performed using IBM SPSS version 24.0. Results : 1. The initial degree of facial palsy showed statistical significance with age. The older the age, the more severe the initial palsy. 2. Following treatment degree of facial palsy was statistically significant with age, hypertension, and fasting blood sugar (FBS). The higher the value, the slower the recovery from facial palsy. There was a statistical significance with the number of treatments in a Korean medical hospital. The more frequent the treatment, the faster the facial palsy recovery. 3. Degree of facial palsy after 12 months was statistically significant with age, hypertension, diabetes, FBS, and the initial severity of facial palsy. The higher the value, the slower the facial palsy recovery. 4. Sex, left or right sided palsy, alcohol consumption, smoking, history of facial palsy, season of onset, total number of treatments and bio chemistry (BC), complete blood cell count (CBC), urinalysis (UA) factors had no statistical significance with prognosis of facial palsy. Conclusion : Age, season of onset, hypertension, diabetes, FBS, initial severity of facial palsy, and the number of treatments at a Korean medical hospital showed statistical significance. The number of treatments at the Korean medical hospital positively correlated with facial palsy prognosis, and the others variables showed a negative correlation with facial palsy prognosis.

Prognostic factors for facial nerve palsy in a pediatric population: A retrospective study and review.

To identify and analyze factors influencing the outcome of facial nerve palsy (FNP) in a pediatric population. Retrospective study. Sixty-seven pediatric patients (72 consecutive cases) diagnosed with and treated for FNP were divided into two severity subgroups. Associations between recovery in these groups and categorical variables were assessed using the Fisher exact test and for age using the t test. Mean age on admission was 12.0 ± 4.5 years. Neither FNP outcome (graded by severity) nor improvement rates (expressed as the percentage of patients achieving a higher FNP grade over time) were influenced by gender, affected side, presence of polyneuropathy, etiology, or recurrent or familial FNP. In cases with comparable final outcome, improvement rates of those diagnosed with severe FNP on presentation (38.9% of cases) were significantly higher than mild-to-moderate FNP. Of the 47 patients who attended a follow-up examination 2 months after discharge, 70.2% have already recovered (by at least one House-Brackmann [H-B] grade) by the time they were discharged, whereas 90.9% achieved H-B grade ≤2, and 72.3% fully recovered (H-B grade 1) 2 months postdischarge. Adding antiviral medication did not affect FNP improvement rates or outcomes. Rates of infectious and traumatic etiology in our patients were higher than reported for adults, but the most common etiology-as in those adults-was idiopathic. Routine extended diagnostic workup was not helpful, and antiviral medications were ineffective. The prognosis of FNP in pediatric patients is excellent, with 90% recovery by 2 months after initial presentation. 4 Laryngoscope, 127:1175-1180, 2017.

Clinical Characteristics and Prognosis of Facial Nerve Palsy in Children

Clinical Characteristics and Prognosis of Facial Nerve Palsy in Children

Increased Mean Platelet Volume in Patients with Bell’s Palsy

OBJECTIVE: The aim of this study is to investigate the mean platelet volume (MPV) levels in patients with Bell palsy (BP). Moreover, we aimed to find out any correlation between MPV levels and the severity and prognosis of BP. MATERIALS and METHODS: The study group consisted of 30 subjects who presented with BP and 30 control subjects with no evidence of facial nerve pathology. The evaluation of subjects included a detailed history, general physical examination, and assessment of laboratory blood parameters. RESULTS: The mean MPV and platelet distribution width (PDW) values in patients with BP were significantly higher than the control group (p=0.02, p=0.0001 respectively). The mean platelet count (PC) values in the BP group and control group were similar (p=0.169). There was positive correlation between MPV values and grade of facial paralysis (r=0.716, p=0.0001). Also, there was positive correlation between PDW values and grade of facial paralysis (r=0.376, p=0.041). In contrast, there was no correlation between MPV and PDW values and prognosis of facial paralysis (r= 0.275, p=0.142; r= 0.073, p=0.703 respectively). CONCLUSION: There is no previous study that has investigated the association between MPV values and BP in the literature. Higher MPV values in BP patients may be a predictor of worse severity.

Neutrophil-Lymphocyte Ratio

The aim of this study was to investigate whether neutrophil-lymphocyte ratio (NLR) levels are elevated in patients with Bell palsy (BP). Moreover, we aimed to find out whether there is a correlation between NLR levels and the severity and prognosis of BP. The study group consisted of 25 subjects who presented with BP and 25 control subjects with no evidence of facial nerve pathology. The subjects underwent a general physical examination; an assessment of laboratory blood parameters; and a cranial magnetic resonance imaging, using gadolinium as a contrast medium. The mean (SD) NLR values were 2.16 (0.80) in the patients with BP and 1.36 (0.48) in the control group. The mean NLR values in the patients with BP were significantly higher than in the control group (P = 0.0001). There was a positive correlation between NLR values and grade of facial paralysis (r = 0.661, P = 0.0001). The mean (SD) NLR values in the grades III, IV, V, and VI BP groups were 1.40 (0.54), 1.78 (0.44), 3.00 (0.63), and 2.60 (0.54), respectively. The mean NLR values in the grade V BP group were significantly higher than in the other groups (P = 0.0001). In addition, there was a positive correlation between NLR values and prognosis of facial paralysis (r = 0.239, P = 0.251). There is no previous study that investigated the association between NLR and BP in the literature. Higher NLR values in patients with BP may be a predictor of worse prognosis.

Assesment, diagnosis and prognosis of bells palsy: a literature review

Facial (VII th cranial nerve) palsy is a condition that affects 1 in 5000 people worldwide. More recently it has appeared as one form of the neural manifestations of infection by the Human Immunodeficiency Virus. As such it is likely that this condition will feature more prominently in the caseload of physiotherapists. Therefore the purpose of this paper is to present to physiotherapists existing knowledge on the diagnosis, objective assessment and prognosis of facial palsy through a literature review. All available primary and secondary sources of literature were obtained through a search of Medline, Sabinet, PEDRO, the Cochrane library and a wide Google search. Objective ways of assessing Bells palsy and its recovery as used currently by the Belly Palsy Association and accepted by the American Academy of Otolaryngology and Head and Neck, are presented together with diagnosis and prognosis.

Facial Paralysis Associated With Cholesteatoma

Report the clinical presentation and outcome of the cases of 13 patients with facial paralysis and acquired middle ear and mastoid cholesteatoma. Patients with acquired cholesteatoma of the middle ear presenting with facial paralysis. Surgical treatment of the cholesteatoma and decompression of the facial nerve. The type and the timing of surgery, the intraoperative findings, and the postoperative facial nerve results were analyzed and related to the preoperative facial nerve function. All patients treated less than 7 days after the onset of the paralysis showed a normal facial function at long-term follow-up; patients who were operated on 7 days or more after the onset of paralysis showed a variable outcome. Statistical analysis showed a bigger number of House-Brackmann grade I in patients operated on within the first week of paralysis (p = 0.031). The prognosis of facial paralysis is related to the time of intervention. Early diagnosis and treatment of cholesteatoma represent, however, the mainstay of treatment.

Clinical data and prognosis in 1521 cases of Bell's palsy

Bell's palsy or idiopathic facial paralysis (IFP) is frequently encountered on otolaryngology practice. The early identification of those patients is of paramount importance. Although electroneurography and clinical palsy staging are currently the method of choice to indicate the prognosis in Bell's palsy, this electrophysiological test is not universally available. This paper tried to identify other options of prognosis evaluation based on clinical aspects and minimal electrical stimulation test allowing a prognosis measurement in any condition.We reviewed 1521 cases of Bell's palsy, analyzing clinical data and their prevalence. The following aspects were statistically evaluated: sex, age, paralyzed side, installation mode, previous symptoms, associated symptoms, and minimal electrical stimulation test (Hilger's test).Our data indicated that patients above 60 years old had worse prognosis in comparison with patients under 30 years old. A progressive mode of paralysis installation, absence of previous symptoms, concomitant vertigo, and response superior to 3.5 mA at the minimum electrical stimulation test were also related to a worse prognosis. On the other hand, the absence of concomitant symptoms, diminished tearing, and sudden onset were related to a better prognosis.We concluded that clinical factors and the minimal electrical stimulation test could indicate the prognosis of facial palsy when the electroneurography is not available.

Prediction of prognosis in facial nerve palsy using constellation diagram.

Prediction of the prognosis of facial nerve palsy has been attempted using values obtained by neurophysiological examinations. However, the values obtained by these methods are only a cross-section of the entire course of the palsy. In order to assess more simply and concisely the prognosis of the disease during the early stage, we applied the constellation diagram method to depict the course of mimetic movement diagrammatically.

Long-term results of severe facial paralysis.

When axonal degeneration is present, prognosis of facial paralysis is bad. This finding may be obtained by electroneurography. Axonotmesis [1] is considered when the amplitude reduction of the evoked motor potential is bigger than 70% compared to the uninvolved side. As we are performing in our Department a prospective study to establish the influence of therapeutic attitude in the clinical evolution of Bell’s palsy, the aim of the present study is to evalute the long-term functional status of patients who presented severe axonal degeneration.

Virus-associated demyelination in the pathogenesis of Bell's palsy.

Idiopathic peripheral facial palsy (Bell’s palsy) is a common neuropathy that results from an intrinsic lesion of the seventh cranial nerve. To date, many hypotheses have been presented to explain the etiology of this disorder [1, 2]. However, since the prognosis of facial paralysis is generally good and postmortem studies are quite rare [3], it is difficult to establish the true pathologic nature of Bell’s palsy. Even the site along the facial nerve of the lesion is still uncertain.

Experimental studies on antidromic evoked potential of the facial nerve.

A method of recording antidromic evoked potential (AEP) of the facial nerve is supposed to have advantages over conventional tests, such as evoked electromyography (eEMG), electroneuronography, and nerve excitation test, in predicting the prognosis of facial palsy in its early stage. However, a comparison of these tests has not yet been studied. The aim of this paper is to investigate the diagnostic value of AEP in predicting the prognosis of facial palsy in comparison with that of eEMG in animal models.

Nerve excitability testing: technical pitfalls and threshold norms using absolute values.

Percutaneous stimulation of the facial nerve is used widely in tests to judge the severity and prognosis of facial paralysis. Several test paradigms are used including nerve excitability threshold (NET), the maximum stimulation test (MST), and electroneuronography (EnoG). Consistent technique and careful control of variables are essential to achieve accurate test results. The sources of variability examined in this study were age, gender, body weight, and the use of electrode paste; the NET was used as the test method. The facial NET in 120 adults without a history of facial paralysis increased linearly with age (P = .0004) and with body weight (P < .0001) and was higher in men than in women adjusted for age and weight (P = .0001). The mean NET +/- SD was 0.7 +/- 0.27 mA in the upper division using the eyelid twitch as an end point, and 1.2 +/- 0.40 mA in the lower division. There was no statistically significant difference in the results between sides. The NET was falsely elevated by the use of electrode paste, presumably due to current shunting away from the nerve. Based on the technique described herein, an absolute NET of > or = 1.25 mA in the upper division or an absolute NET > or = 2.0 mA in the lower division of the human facial nerve is statistically abnormal. These norms are not applicable to grossly obese patients or patients with facial edema or inflammation. Statistical norms allow the NET results to be reported on a continuous scale rather than the dichotomous scale used in the past. The predictive power of the NET will be greatly enhanced by basing test interpretation on both statistical and clinical significance.