IOWA CITY, Iowa -- How to best treat patients with Bell's palsy who are at high risk of permanent loss of facial muscle control has remained a controversial subject among physicians for decades. However, results of a 15-year study led by University of Iowa Health Care researchers may help to finally settle the debate.
"We hope these findings will help change the attitudes of a lot of different people," said Bruce Gantz, M.D., UI professor and head of otolaryngology.
Timing and strategy are critical when it comes to the subgroup of patients with Bell's palsy who are at the greatest risks for permanent damage. The study results indicate that identifying this patient population and their subsequent surgical treatment must occur within two weeks of the onset of paralysis.
"If we are going to have any impact, the surgery has to come within the first two weeks," Gantz stressed.
Bell's palsy is partial or complete facial muscle paralysis resulting from a certain dysfunctional cranial nerve that is believed to be damaged by the herpes simplex virus type I. The condition affects about 40,000 Americans per year. Although medication will help most individuals fully or almost fully recover from Bell's palsy paralysis, about 10 to 15 percent of patients will not recover unless additional measures are taken.
The study had three related goals, all attempting to answer the primary questions troubling many clinicians treating patients with Bell's palsy. The researchers wanted to determine how to best identify which patients will be left with poor outcomes, establish whether surgical decompression might improve these patients' chances of recovery, and finally, figure out what, if any, impact time had on treatment.
The study results were based on patient outcomes of individuals with Bell's palsy treated at the UI Hospitals and Clinics, the University of Michigan and the Baylor College of Medicine.