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Hyperbaric oxygen therapy for Bell's palsy.
N Julian Holland1, Jonathan M Bernstein, John W Hamilton
1ENT Department, St Michael’s Hospital, Bristol, UK. njulianholland@hotmail.com.
Hyperbaric oxygen therapy (HBOT) may improve facial function recovery in Bell's palsy patients. However, evidence quality is very low due to a lack of blinded outcome assessors in trials, necessitating further research.
Area of Science:
- Neurology
- Otolaryngology
- Hyperbaric Medicine
Background:
- Bell's palsy is acute, idiopathic unilateral facial weakness.
- Symptoms include rapid onset, maximal weakness within two days, ear discomfort, sound sensitivity, and reduced tearing.
Purpose of the Study:
- To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) for facial function recovery in adults with moderate to severe Bell's palsy.
Main Methods:
- Systematic search of multiple databases and hyperbaric literature sources.
- Included randomized controlled trials (RCTs) or quasi-RCTs of adults (age >16) with moderate to severe Bell's palsy.
- Studies required blinding of outcome assessors; HBOT at ≥1.2 ATA as adjuvant therapy was considered.
Main Results:
- No RCTs met the eligibility criteria due to lack of blinding.
- One excluded trial (79 participants) suggested HBOT improved recovery compared to prednisone (95% vs. 76%).
- This trial lacked blinded outcome assessment, yielding very low-quality evidence.
Conclusions:
- Very low-quality evidence suggests potential benefit of HBOT for Bell's palsy.
- The single trial's exclusion due to methodological flaws highlights the need for high-quality RCTs.
- Further rigorous research is required to confirm HBOT efficacy.