Therapeutic management of traumatic facial palsy: a systematic review

Purpose: Trauma is a common cause of facial nerve palsy, accounting for 3% of all cases. While many facial palsies resolve with medical treatment, some require surgical intervention. This systematic review aimed to determine the best therapeutic strategy for traumatic facial palsy. Methods: We reviewed eligible articles for patient demographics, pre-treatment assessment, parameters of selected treatment, type of treatment, outcomes, and post-treatment assessment. Results: Among 135 unique citations, 32 studies were considered eligible, reporting treatment data for 2079 patients. Most studies (n = 30) were case series. The main proposed therapeutic strategies were medical, surgical, or a combination of both. For almost all the selected studies, the House-Brackmann (HB) scale was used to estimate the severity of facial palsy. Conclusion: Based on the existing literature, a standardized guideline for the treatment of traumatic facial palsy is not well delineated, due to the extreme heterogeneity of available therapeutic choices and the lack of standardized patient stratification.