Rehabilitation of Bells’ palsy from a multi-team perspective

Abstract

Conclusions Defectively healed facial paralysis causes difficulties to talk and eat, involuntary spasms (synkinesis), and cosmetic deformities which can give rise both to severe psychological and physical trauma. A team consisting of Ear-Nose-Throat specialists, Plastic surgeons and Physiotherapists can offer better care, treatment and outcome for patients suffering from Bells' palsy.

Objectives Patients suffering from Bells' palsy from all ENT hospitals in Sweden and the University Hospital in Helsinki has been included.

Methods Results have been drawn and statistically processed for different outcomes from a prospective, double blind cross over study. Results from a pilot surgical study and therapeutic results from physiotherapy studies have been included. Ideas concerning different kinds of surgery will be reviewed and the role of physiotherapy discussed.

Results According to common results, treatment with Prednisolone enhances the recovery rate and should, if possible, be used early in the course. Sunnybrook grading at 1 month after onset most accurately predicts non-recovery at 12 months in Bells’ palsy and a risk factor curve will be presented in order to predict outcome and selection of patients for undergoing facial surgery. This report is focusing on how to handle patients with Bells’ palsy from a multi-rehabilitation team point of view, and what will be recommended to provide these patients with the best clinical and surgical help.

Keywords:

• Bells’ palsy
• rehabilitation
• cross-facial surgery
• physiotherapy
• risk-factor curve

Acknowledgement

The author want to thank the team around the Bells palsy patients in Stockholm and Uppsala, Sweden and Helsinki, Finland: B. Stark, MD, F. Farnebo, MD, Anna Stiernqvist-Desatnik, MD, S. Axelsson, MD, L. Jonsson, MD, M. Engström, MD, T. Berg, MD, L. Hammarstedt, MD, E. Marsk, MD, N. Bylund, MD, D. Johansson, MD, M. Kanerva, MD, Anne Pitkäranta, MD, Susanne Odin, Physiotherapist, C. Ekwall, Physiotherapist, and N. Hadziosmanovic, statistician.

Declaration of interest

The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.