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Inicio Acta Otorrinolaringológica Española Variations in the treatment of acute peripheral facial paralysis. A nationwide s...
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Vol. 75. Issue 1.
Pages 31-39 (January - February 2024)
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Vol. 75. Issue 1.
Pages 31-39 (January - February 2024)
Original article
Variations in the treatment of acute peripheral facial paralysis. A nationwide survey
Encuesta nacional sobre la variabilidad en el tratamiento de la parálisis facial periférica aguda
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José Manuel Morales-Pueblaa,b,c,d,
Corresponding author
, Mireya Fernández-Fourniere,f, Antoni Plana-Blancog,h,i, Luis Lassalettaa,b,c,d
a Department of Otolaryngology, La Paz University Hospital, IdiPaz, Paseo de La Castellana 261, 28046, Madrid, Spain
b Otology Commission of the Spanish Society of Otolaryngology and Head and Neck Surgery, Spain
c Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, U761, Madrid, Spain
d Autonomous University of Madrid, School of Medicine, Madrid, Spain
e Neurology Department, La Paz University Hospital, IdiPaz, Paseo de La Castellana 261, 28046, Madrid, Spain
f Neuroepidemiology Coordinator of the Spanish Society of Neurology, Spain
g Primary Care Center of Balàfia-Pardinyes-Secà de St. Pere, Lleida, Spain
h Neurology Coordinator of the Spanish Society of Family and Community Medicine, Spain
i University of Lleida, School of Medicine, Lleida, Spain
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Tables (3)
Table 1. Online survey questions.
Table 2. Steroid and antiviral therapy dosage recommended based on the main clinical guidelines.
Table 3. Global distribution by specialty. The global percentage of participation by specialty and expertise (specialist or resident) is shown. The last column represents the percentage of specialist and residents in each specialty subgroup.
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Additional material (1)
Abstract
Background

Acute peripheral facial paralysis may be diagnosed and treated by different specialists.

Objective

The aim of this study was to explore the variability in the treatment of Bell’s palsy (BP) and Ramsay Hunt Syndrome (RHS) among different medical specialties.

Methods

An anonymous nationwide online survey was distributed among the Spanish Societies of Otorhinolaryngology (ORL), Neurology (NRL) and Family and Community Medicine (GP).

Results

1039 responses were obtained. 98% agreed on using corticosteroids, ORL using higher doses than NRL and GP. Among all, only 13% prescribed antivirals in BP routinely, while 31% prescribed them occasionally. The percentage of specialists not using antivirals for RHS was 5% of ORL, 11% of NRL, and 23% of GP (GP vs. NRL p = 0.001; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0,002). 99% recommended eye care. Exercises as chewing gum or blowing balloons were prescribed by 45% of the participants with statistically significant differences among the three specialties (GP vs. NRL p = 0.021; GP vs. ORL p < 0.0001; NRL vs. ORL p = 0.002).

Conclusion

There is general agreement in the use of corticosteroids and recommending eye care as part of the treatment of acute peripheral facial paralysis. Yet, there are discrepancies in corticosteroids dosage, use of antivirals and recommendation of facial exercises among specialties.

Keywords:
Facial paralysis
Corticosteroid therapy
Antiviral therapy
Eye care
Facial nerve rehabilitation
Resumen
Introducción

La parálisis facial periférica aguda puede ser diagnosticada y tratada por diferentes especialistas.

Objetivo

El objetivo de este estudio es analizar la variabilidad entre especialidades en el tratamiento de la parálisis de Bell (PB) y del síndrome de Ramsay-Hunt (SRH).

Métodos

Se distribuyó una encuesta anónima online entre los miembros de la Sociedad Española de Otorrinolaringología (ORL), la Sociedad Española de Neurología (NRL) y la Sociedad de Medicina Familiar y Comunitaria (MF).

Resultados

Se recopilaron 1039 respuestas. El 98% de los participantes coincidieron en el uso de corticoides, los ORL utilizaron dosis más altas que NRL y MF. Del total de encuestados, el 13% recomendaba antivirales en la PB de manera rutinaria, mientras que el 31% los recomendaba en ocasiones. El 5% de ORL, 11% de NRL, y 23% de MF (MF vs. NRL p = 0.001; MF vs. ORL p < 0.0001; NRL vs. ORL p = 0,002) no utilizaba antivirales en el tratamiento del SRH. El 99% de añadía cuidados del ojo al tratamiento de la parálisis facial. El 45% de los participantes aconsejaba ejercicios faciales como mascar chicle o inflar globos con diferencias estadísticamente significativas entre las tres especialidades (MF vs. NRL p = 0.021; MF vs. ORL p < 0.0001; NRL vs. ORL p = 0.002).

Conclusión

Existe acuerdo general en la utilización de corticoides y recomendar cuidados del ojo como parte del tratamiento de la parálisis facial periférica. A pesar de ello, existen diferencias en las dosis utilizadas, la utilización de antivirales o la recomendación de ejercicios faciales entre especialidades.

Palabras clave:
Parálisis facial
Corticosteroides
Antivirales
Cuidados del ojo
Rehabilitación de parálisis facial

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