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Facial Plast Surg 2025; 41(03): 359-363
DOI: 10.1055/a-2359-5280
Original Research

Ophthalmic Assessment and Management in Acute Facial Palsy

Mohsan Malik 
1   Adnexal Service, Moorfields Eye Hospital, London, United Kingdom
,
Raheej Shamim Khan
2   Department of Occuloplastic, Machester Royal Eye Hospital, Oxford Rd, Manchester, United Kingdom
,
Eamon Shamil 
3   Eamon Shamil FRCS (ORL-HNS), The Royal National ENT & Eastman Dental Hospital, University College London NHS Foundation Trust, Huntley Street, London, United Kingdom
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Abstract

This article aims to provide insights into emerging concepts in ophthalmic manifestations in patients with facial palsy and discusses considerations used to develop patient-specific management plans in acute management.

Keywords

facial palsy - brow ptosis - lagophthalmos - ectropion - exposure keratopathy


Publication History

Accepted Manuscript online:
03 July 2024

Article published online:
16 July 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Spencer CR, Irving RM. Causes and management of facial nerve palsy. Br J Hosp Med (Lond) 2016; 77 (12) 076-SLD
    CrossrefPubMedSearch in Google Scholar
  • 2 Norris JH, Longmire NM, Kilcoyne S, Johnson D, Fitzpatrick R, Klassen AF. Exploring patient experience of facial nerve palsy to inform the development of a PROM. Plast Reconstr Surg Glob Open 2019; 7 (01) e2072
    CrossrefPubMedSearch in Google Scholar
  • 3 Sohrab M, Abugo U, Grant M, Merbs S. Management of the eye in facial paralysis. Facial Plast Surg 2015; 31 (02) 140-144
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Nemoto Y, Sekino Y, Kaneko H. Facial nerve anatomy in eyelids and periorbit. Jpn J Ophthalmol 2001; 45 (05) 445-452
    CrossrefPubMedSearch in Google Scholar
  • 5 Lou J, Yu H, Wang F-Y. A review on automated facial nerve function assessment from visual face capture. IEEE Trans Neural Syst Rehabil Eng 2020; 28 (02) 488-497
    CrossrefPubMedSearch in Google Scholar
  • 6 Mat Lazim N, Ismail H, Abdul Halim S, Nik Othman NA, Haron A. Comparison of 3 grading systems (House-Brackmann, Sunnybrook, Sydney) for the assessment of facial nerve paralysis and prediction of neural recovery. Medeniyet Med J 2023; 38 (02) 111-119
    CrossrefPubMedSearch in Google Scholar
  • 7 Ross BG, Fradet G, Nedzelski JM. Development of a sensitive clinical facial grading system. Otolaryngol Head Neck Surg 1996; 114 (03) 380-386
    CrossrefPubMedSearch in Google Scholar
  • 8 Rickenmann J, Jaquenod C, Cerenko D, Fisch U. Comparative value of facial nerve grading systems. Otolaryngol Head Neck Surg 1997; 117 (04) 322-325
    CrossrefPubMedSearch in Google Scholar
  • 9 Scheller C, Wienke A, Tatagiba M. et al. Interobserver variability of the House-Brackmann facial nerve grading system for the analysis of a randomized multi-center phase III trial. Acta Neurochir (Wien) 2017; 159 (04) 733-738
    CrossrefPubMedSearch in Google Scholar
  • 10 Hu WL, Ross B, Nedzelski J. Reliability of the Sunnybrook facial grading system by novice users. J Otolaryngol 2001; 30 (04) 208-211
    CrossrefPubMedSearch in Google Scholar
  • 11 Cabrol C, Elarouti L, Montava AL. et al. Sunnybrook facial grading system: intra-rater and inter-rater variabilities. Otol Neurotol 2021; 42 (07) 1089-1094
    CrossrefPubMedSearch in Google Scholar
  • 12 Kanerva M, Poussa T, Pitkäranta A. Sunnybrook and House-Brackmann Facial Grading Systems: intrarater repeatability and interrater agreement. Otolaryngol Head Neck Surg 2006; 135 (06) 865-87
    CrossrefPubMedSearch in Google Scholar
  • 13 Tan P, Siah WF, Wong J, Malhotra R. Validation of CADS grading scale: an ophthalmic specific grading instrument for facial nerve palsy. Ophthal Plast Reconstr Surg 2017; 33 (06) 419-425
    CrossrefPubMedSearch in Google Scholar
  • 14 Gupta S, Mends F, Hagiwara M, Fatterpekar G, Roehm PC. Imaging the facial nerve: a contemporary review. Radiol Res Pract 2013; 2013: 248039
    PubMedSearch in Google Scholar
  • 15 Madhok VB, Gagyor I, Daly F. et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2016; 7 (07) CD001942
    PubMedSearch in Google Scholar
  • 16 Jalali MM, Soleimani R, Soltanipour S, Jalali SM. Pharmacological treatments of Bell's palsy in adults: a systematic review and network meta-analysis. Laryngoscope 2021; 131 (07) 1615-1625
    CrossrefPubMedSearch in Google Scholar
  • 17 Berg T, Bylund N, Marsk E. et al. The effect of prednisolone on sequelae in Bell's palsy. Arch Otolaryngol Head Neck Surg 2012; 138 (05) 445-449
    CrossrefPubMedSearch in Google Scholar
  • 18 Prescott CA. Idiopathic facial nerve palsy (the effect of treatment with steroids). J Laryngol Otol 1988; 102 (05) 403-407
    CrossrefPubMedSearch in Google Scholar
  • 19 Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngol 2008; 265 (07) 743-752
    CrossrefPubMedSearch in Google Scholar
  • 20 Sullivan FM, Swan IR, Donnan PT. et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med 2007; 357 (16) 1598-1607
    CrossrefPubMedSearch in Google Scholar
  • 21 Fujiwara T, Haku Y, Miyazaki T, Yoshida A, Sato SI, Tamaki H. High-dose corticosteroids improve the prognosis of Bell's palsy compared with low-dose corticosteroids: a propensity score analysis. Auris Nasus Larynx 2018; 45 (03) 465-470
    CrossrefPubMedSearch in Google Scholar
  • 22 Fujiwara T, Iwata S, Hosokawa Y, Mitani S. Intratympanic corticosteroid for Bell's palsy and Ramsay Hunt syndrome: systematic review and meta-analysis. Auris Nasus Larynx 2022; 49 (04) 599-605
    CrossrefPubMedSearch in Google Scholar
  • 23 Tiemstra JD, Khatkhate N. Bell's palsy: diagnosis and management. Am Fam Physician 2007; 76 (07) 997-1002
    PubMedSearch in Google Scholar
  • 24 Allen D, Dunn L. Aciclovir or valaciclovir for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2004; 3: CD001869
    PubMedSearch in Google Scholar
  • 25 Neville C, Gwynn T, Young K. et al. Comparative study of multimodal therapy in facial palsy patients. Arch Plast Surg 2022; 49 (05) 633-641
    Thieme ConnectPubMedSearch in Google Scholar
  • 26 Martineau S, Rahal A, Piette E, Moubayed S, Marcotte K. The “mirror effect plus protocol” for acute Bell's palsy: a randomized controlled trial with 1-year follow-up. Clin Rehabil 2022; 36 (10) 1292-1304
    CrossrefPubMedSearch in Google Scholar
  • 27 Watson GJ, Glover S, Allen S, Irving RM. Outcome of facial physiotherapy in patients with prolonged idiopathic facial palsy. J Laryngol Otol 2015; 129 (04) 348-352
    CrossrefPubMedSearch in Google Scholar
  • 28 Proske U, Morgan DL, Gregory JE. Thixotropy in skeletal muscle and in muscle spindles: a review. Prog Neurobiol 1993; 41 (06) 705-721
    CrossrefPubMedSearch in Google Scholar
  • 29 Ziahosseini K, Venables V, Neville C, Nduka C, Patel B, Malhotra R. Occurrence and severity of upper eyelid skin contracture in facial nerve palsy. Eye (Lond) 2016; 30 (05) 713-717
    CrossrefPubMedSearch in Google Scholar
  • 30 Jamison A, Patel BCK, Malhotra R. Horizontal shortening of the lower eyelid margin in facial nerve palsy. Eye (Lond) 2024; 38 (01) 205-209
    CrossrefPubMedSearch in Google Scholar
  • 31 Findlay Q, Reid K. Dry eye disease: when to treat and when to refer. Aust Prescr 2018; 41 (05) 160-163
    CrossrefPubMedSearch in Google Scholar
  • 32 Stevens S. Taping an eyelid closed. Community Eye Health 2012; 25 (78) 36
    PubMedSearch in Google Scholar
  • 33 Sri Shanmuganathan V, Kethees A, Chang SH, Papageorgiou K. The role of external eyelid weights in acute facial palsy: functional and aesthetic considerations. Oxf Med Case Rep 2018; 2018 (01) omx087
    CrossrefPubMedSearch in Google Scholar
  • 34 Kitchens J, Kinder J, Oetting T. The drawstring temporary tarsorrhaphy technique. Arch Ophthalmol 2002; 120 (02) 187-190
    CrossrefPubMedSearch in Google Scholar
  • 35 McInnes AW, Burroughs JR, Anderson RL, McCann JD. Temporary suture tarsorrhaphy. Am J Ophthalmol 2006; 142 (02) 344-346
    CrossrefPubMedSearch in Google Scholar