Acute Peripheral Facial Palsy: Recent Guidelines and a Systematic Review of the Literature

Background This study reviews recent literature on facial palsy guidelines and provides systematic reviews on related topics of interest. Methods An electronic database search was performed to identify recent guidelines dealing with facial nerve systematic reviews and recent meta-analysis published between 2011 and 2019 (inclusive). The literature search used the search terms Bell's palsy, Ramsay-Hunt syndrome, Facial palsy, Facial Facial paresis, Guideline, Meta-analysis, Systematic review, and Randomized controlled trial. Only studies written in English were used. Results The characteristics of treatment trends for facial palsy have been reviewed over the past decade. The most prominent change noted may be the shift from the conventional House-Brackmann facial nerve grading system to the Sunnybrook and eFACE systems. In addition, the results of serial meta-analyses indicate increasing agreement with the use of surgical decompression of the facial nerve. Beyond steroids or combined steroid-antiviral treatment, various novel drugs and treatments have been tried. For long-standing facial paralysis and postparetic synkinesis sequelae after facial facial reanimation has been highlighted and the necessity of new paradigms have been raised. Conclusion For peripheral facial paralysis, various changes have been made, not only in the facial nerve grading systems, but also in medical treatments, from surgical procedures to rehabilitation, during the last decade.