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Acoustic Radiation Force Impulse (ARFI) Elastography as a diagnostic and monitoring tool for Bell's palsy: A
Murat Toprak1, Nurşen Toprak2, Mehmet Reşit Oncu3
1Department of Physical Medicine and Rehabilitation, Medical Faculty of Van Yüzüncü Yıl University, Turkey.
Objective:
To evaluate ARFI elastography as a diagnostic and monitoring tool in Bell's palsy by comparing affected and unaffected facial muscles, pre- and post-treatment.
Methods:
Thirty patients with Bell's palsy (17 females and 13 males, mean age 44.6 ± 16.76, range:18-72 years) were assessed using Clinical (House-Brackmann grading), electrophysiologic (EMG), and ultrasonographic (ARFI-elastography). In order to assess the diagnostic value of elastosonography, we compared the scores between the paretic and nonparetic sides of the face. Measurements were obtained bilaterally at baseline and after four weeks of physical therapy.
Results:
The initial degree of facial nerve paralysis was 5.13 ± 0.89 on the House-Brackmann scale (range 4-6). This parameter significantly decreased after the treatment, measuring 2.53 ± 0.81. Post-treatment, significant improvements were observed in EMG and ARFI values, particularly in the orbicularis oculi and masseter muscles. No significant correlation was found between EMG and ARFI elastographic parameters.
Conclusions:
ARFI elastography is a promising, non-invasive tool for monitoring Bell's palsy recovery, though standardization is needed.
