Role of Neuromuscular Electrical Stimulation in Bell’s Palsy: A Case Study of Three Patients

Bell's palsy is an idiopathic, unilateral facial paralysis, caused by a malfunction anywhere along the facial nerve's peripheral portion, from the pons distally. Bell's palsy is treated by removing the cause of nerve injury, strengthening the face muscles, and restoring facial function. Physical therapy in the form of neuromuscular electrical stimulation (NMES), massage and facial exercises is used as adjuvant to hasten recovery. The aim of this study is to access of role of neuromuscular electrical stimulation (NMES) treatment in Bell’s palsy patients. A detailed neurological assessment of three patients was done with emphasis on facial muscles and severity of paralysis was graded according to House Brackmann scale (HBS). Conventional physiotherapy was given in the form of electrical stimulation, facial massage, exercises and functional re-education on a daily basis. Patients were assessed at weekly and 1months after the treatment. They experienced complete recovery within 1month follow-up, no recurrence was observed and all patients have normal facial movement. Physiotherapy in the form of NMES and facial exercises has a effective role in the early management of Bell’s palsy. Keywords: Bell’s palsy; neuromuscular electrical stimulation; House Brackmann scale; physiotherapy.

Characteristic of Bell’s Palsy in Clinical Neurologic at Sanglah Hospital Denpasar Bali Indonesia

Introduction/Aim: Bell's Palsy is a lower motor neuron facial weakness caused by idiopathic etiology with the absence of other neurologic diseases. The incidence of this syndrome is around 23 cases per 100,000 people each year. The clinical manifestations are sometimes being considered to be a stroke or tumor. This study was conducted to find characteristic of bell’s palsy in clinical neurologic at Sanglah Hospital Denpasar, Bali Indonesia Methods: This study is a descriptive study with a cross sectional design in polyclinic of Sanglah Hospital, Denpasar for the period 2016 to 2019. Sampling was carried out using a consecutive non-random sampling method. Result: A total of 31 subjects in rainy season 51.6% having female 61.3% and male 38.7%, with the range of age 46-55 years old. Most of the patients complaints the weakness of the right face 58.1%, postauricular pain 64.5%. Electroneuromyography examination with seddon classification having results of Neuropraxia 67.7%. Conclusion: Characteristic of bell’s palsy in clinical neurologic most of participant in woman with postauricular pain and neuropraxia Keywords: Bell's Palsy, neuropraxia, postauricular pain, seddon classification.

Gambaran Peningkatan Fungsional Pasien Bell’s Palsy Setelah Pemberian Kombinasi Transcutaneous Electrical Nerve Stimulation (Tens) Dan Exercise : Literature Review

Bell's palsy is an acute weakness or paralysis of the peripheral facial nerve with no known cause. The incidence of Bell's palsy is about 40-70% of all acute peripheral facial nerve palsy, the average prevalence ranges from 10-30% per 100,000 population per year) Data collected from 4 hospitals in Indonesia shows that the frequency of Bell's palsy shows 19.55% of all cases of neuropathy. The incidence of Bell's palsy ranges from 23 cases per 100,000 people annually, most of the cases 85 % cured within 1-2 months which occurs in 8% of cases. The literature Review research is to analyze the description of the functional improvement of Bell's Palsy patients after the combination of Transcutaneous Electrical Nerve Stimulation (TENS) and Exercise. The selection of articles in this study used the PICO mnemonic design. 160 reviewed articles via PubMed and google scholar, article search via PubMed (1), Google Scholar (4). Inclusion and exclusion criteria according to keywords, published in 2010-2021. The results of the analysis of the literature review of 5 articles showed that the male gender was at risk of experiencing Bell's palsy, namely 29 (52.7%) compared to the female sex, which was 26 (47.3%). Functional recovery in Bell's palsy from the mean pre-test and post-test scores, it can be seen that the average pre-test is 5.19 and the average post-test is 3.65. Improved functional recovery in Bell's palsy patients after administering TENS with a combination of Exercise with massage methods.Keywords: Bell’s palsy, TENS and Massage AbstrakBell's palsy adalah kelemahan akut atau kelumpuhan saraf wajah perifer tanpa diketahui penyebabnya. Kejadian Bell's palsy sekitar 40-70% dari seluruh kelumpuhan saraf fasialis perifer akut, prevalensi rata-rata berkisar 10-30% per 100.000 penduduk per tahun) Data yang dikumpulkan dari 4 rumah sakit di Indonesia menunjukkan bahwa frekuensi Bell's palsy menunjukkan 19,55 % dari semua kasus neuropati. Angka kejadian Bell's palsy berkisar 23 kasus per 100.000 orang setiap tahunnya, sebagian besar 85% sembuh dalam waktu 1-2 bulan yang terjadi pada 8% kasus. Penelitian Literatur Review ini untuk menganalisis gambaran peningkatan fungsional pasien Bell's Palsy setelah pemberian kombinasi Transcutaneous Electrical Nerve Stimulation (TENS) dan Latihan. Pemilihan artikel dalam penelitian ini menggunakan desain mnemonic PICO. 160 artikel yang diulas melalui PubMed dan google sarjana, pencarian artikel melalui PubMed (1), Google Cendekia (4). Kriteria inklusi dan eksklusi menurut kata kunci, terbit tahun 2010-2021. Hasil analisis literature review dari 5 artikel menunjukkan bahwa jenis kelamin laki-laki berisiko mengalami Bell’s palsy yaitu 29 (52,7%) dibandingkan dengan jenis kelamin perempuan, yaitu 26 (47,3%). Pemulihan fungsional pada Bell's palsy dari rerata skor pre-test dan post-test, terlihat bahwa rata-rata pre-test adalah 5,19 dan rata-rata post-test adalah 3,65. Peningkatan pemulihan fungsional pada pasien Bell's palsy setelah pemberian TENS dengan kombinasi Latihan dengan metode pijat.Kata kunci: Bell’s palsy, TENS dan pijat

Corticosteroid Use in Otolaryngology: Current Considerations During the COVID-19 Era

Objective To offer pragmatic, evidence-informed advice on administering corticosteroids in otolaryngology during the coronavirus disease 2019 (COVID-19) pandemic, considering therapeutic efficacy, potential adverse effects, susceptibility to COVID-19, and potential effects on efficacy of vaccination against SARS-CoV-2, which causes COVID-19. Data Sources PubMed, Cochrane Library, EMBASE, CINAHL, and guideline databases. Review Methods Guideline search strategies, supplemented by database searches on sudden sensorineural hearing loss (SSNHL), idiopathic facial nerve paralysis (Bell’s palsy), sinonasal polyposis, laryngotracheal disorders, head and neck oncology, and pediatric otolaryngology, prioritizing systematic reviews, randomized controlled trials, and COVID-19–specific findings. Conclusions Systemic corticosteroids (SCSs) reduce long-term morbidity in individuals with SSNHL and Bell’s palsy, reduce acute laryngotracheal edema, and have benefit in perioperative management for some procedures. Topical or locally injected corticosteroids are preferable for most other otolaryngologic indications. SCSs have not shown long-term benefit for sinonasal disorders. SCSs are not a contraindication to vaccination with COVID-19 vaccines approved by the US Food and Drug Administration. The Centers for Disease Control and Prevention noted that these vaccines are safe for immunocompromised patients. Implications for Practice SCS use for SSNHL, Bell’s palsy, laryngotracheal edema, and perioperative care should follow prepandemic standards. Local or topical corticosteroids are preferable for most other otolaryngologic indications. Whether SCSs attenuate response to vaccination against COVID-19 or increase susceptibility to SARS-CoV-2 infection is unknown. Immunosuppression may lower vaccine efficacy, so immunocompromised patients should adhere to recommended infection control practices. COVID-19 vaccination with Pfizer-BioNTech, Moderna, or Johnson & Johnson vaccines is safe for immunocompromised patients.