Trends in the Treatment of Bell's Palsy

Tom Shokri; Robert Saadi; Eric W. Schaefer; Jessyka G. Lighthall

doi:10.1055/s-0040-1713808

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2020; 36(05): 628-634
DOI: 10.1055/s-0040-1713808

Original Research

Trends in the Treatment of Bell's Palsy

Tom Shokri

¹Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania

,

Robert Saadi

¹Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania

,

Eric W. Schaefer

²Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania

,

Jessyka G. Lighthall

³Section of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania

› Author Affiliations

Abstract

The aim of the study is to: (1) evaluate national trends in care of facial paralysis, namely Bell's palsy, patients to identify the types of treatments patients are receiving and treatment gaps and (2) identify if newer, more complex surgical therapies published in the literature are being employed. Data were collected from the MarketScan Commercial Claims and Encounters Database by Truven Health. From the database, all inpatient and outpatient claims with International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes for facial paralysis/dysfunction between 2005 and 2013 were extracted. Trends in medical and surgical management were evaluated specifically cataloging the use of steroids, antivirals, botulinum toxin, surgical and rehabilitation service current procedural terminology codes. A total of 42,866 of patients with a formal diagnosis of Bell's palsy were identified with 39,292 (92%) adults and 3,754 (8%) children (< 18 years old), respectively. Steroids were provided to 50.1% of children and 59.8% of adults and antivirals were prescribed to 26.2 and 39.4% of the children and adults, respectively. Within the first 2 years after diagnosis, 0.5% of children and 0.9% of adults received surgery, 0.1% of children and 0.8% of adults received botulinum toxin treatments, and 10.9% of children and 21.5% of adults received rehabilitation services. Despite the limitations of a claims database study, results showing trends in care of facial paralysis are still nonsurgical with many patients receiving no treatment at all. Although limited literature has shown an increase in the use of pharmacotherapy as well as techniques including physiotherapy, chemodenervation, and various surgical therapies, these interventions may be underutilized.

Keywords

facial paralysis - bell palsy - facial nerve - synkinesis

Full Text

References

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