{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T21:06:47Z","timestamp":1783544807195,"version":"3.55.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the study is to: (1) evaluate national trends in care of facial paralysis, namely Bell's palsy, patients to identify the types of treatments patients are receiving and treatment gaps and (2) identify if newer, more complex surgical therapies published in the literature are being employed. Data were collected from the MarketScan Commercial Claims and Encounters Database by Truven Health. From the database, all inpatient and outpatient claims with International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes for facial paralysis\/dysfunction between 2005 and 2013 were extracted. Trends in medical and surgical management were evaluated specifically cataloging the use of steroids, antivirals, botulinum toxin, surgical and rehabilitation service current procedural terminology codes. A total of 42,866 of patients with a formal diagnosis of Bell's palsy were identified with 39,292 (92%) adults and 3,754 (8%) children (&lt; 18 years old), respectively. Steroids were provided to 50.1% of children and 59.8% of adults and antivirals were prescribed to 26.2 and 39.4% of the children and adults, respectively. Within the first 2 years after diagnosis, 0.5% of children and 0.9% of adults received surgery, 0.1% of children and 0.8% of adults received botulinum toxin treatments, and 10.9% of children and 21.5% of adults received rehabilitation services. Despite the limitations of a claims database study, results showing trends in care of facial paralysis are still nonsurgical with many patients receiving no treatment at all. Although limited literature has shown an increase in the use of pharmacotherapy as well as techniques including physiotherapy, chemodenervation, and various surgical therapies, these interventions may be underutilized.<\/jats:p>","DOI":"10.1055\/s-0040-1713808","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T22:54:19Z","timestamp":1597359259000},"page":"628-634","source":"Crossref","is-referenced-by-count":17,"title":["Trends in the Treatment of Bell's Palsy"],"prefix":"10.1055","volume":"36","author":[{"given":"Tom","family":"Shokri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Saadi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric W.","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessyka G.","family":"Lighthall","sequence":"additional","affiliation":[{"name":"Section of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,8,13]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.fsc.2015.04.005","article-title":"An evidence-based approach to facial reanimation","volume":"23","author":"N Jowett","year":"2015","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1001\/jamafacial.2015.0399","article-title":"A contemporary approach to facial reanimation","volume":"17","author":"N Jowett","year":"2015","journal-title":"JAMA Facial Plast Surg"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/00129492-200307000-00024","article-title":"Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability","volume":"24","author":"C H Beurskens","year":"2003","journal-title":"Otol Neurotol"},{"issue":"S 03","key":"ref4","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1177\/0194599813505967","article-title":"Clinical practice guideline: Bell's palsy","volume":"149","author":"R F Baugh","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1097\/00005537-199908000-00001","article-title":"Surgical management of Bell's palsy","volume":"109","author":"B J Gantz","year":"1999","journal-title":"Laryngoscope"},{"key":"ref6","first-page":"205","volume-title":"Neuromuscular retraining: non-surgical therapy for facial palsy","author":"H J Diels","year":"2014"},{"key":"ref7","first-page":"145","volume-title":"Management of facial palsy","author":"R Wesley","year":"2012"},{"issue":"02","key":"ref8","first-page":"67","article-title":"Facial paralysis rehabilitation: retraining selective muscle control","volume":"4","author":"R Balliet","year":"1982","journal-title":"Int Rehabil Med"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1007\/s00266-009-9337-9","article-title":"Botulinum toxin injection in long-standing facial paralysis patients: improvement of facial symmetry observed up to 6 months","volume":"33","author":"A G Salles","year":"2009","journal-title":"Aesthetic Plast Surg"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1038\/eye.2012.189","article-title":"Botulinum toxin to improve lower facial symmetry in facial nerve palsy","volume":"26","author":"S A Sadiq","year":"2012","journal-title":"Eye (Lond)"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/j.bjps.2013.04.012","article-title":"Botulinum toxin injection of both sides of the face to treat post-paralytic facial synkinesis","volume":"66","author":"K H Choi","year":"2013","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.amjoto.2004.04.010","article-title":"Physiotherapy in patients with facial nerve paresis: description of outcomes","volume":"25","author":"C H Beurskens","year":"2004","journal-title":"Am J Otolaryngol"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0004-9514(06)70026-5","article-title":"Mime therapy improves facial symmetry in people with long-term facial nerve paresis: a randomised controlled trial","volume":"52","author":"C H Beurskens","year":"2006","journal-title":"Aust J Physiother"},{"issue":"16","key":"ref14","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1056\/NEJMoa072006","article-title":"Early treatment with prednisolone or acyclovir in Bell's palsy","volume":"357","author":"F M Sullivan","year":"2007","journal-title":"N Engl J Med"},{"issue":"11","key":"ref15","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/S1474-4422(08)70221-7","article-title":"Prednisolone and valaciclovir in Bell's palsy: a randomised, double-blind, placebo-controlled, multicentre trial","volume":"7","author":"M Engstr\u00f6m","year":"2008","journal-title":"Lancet Neurol"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.ijporl.2012.02.044","article-title":"Do children with Bell's palsy benefit from steroid treatment? A systematic review","volume":"76","author":"J Pitaro","year":"2012","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref17","first-page":"313","article-title":"Should we use steroids to treat children with Bell's palsy?","volume":"52","author":"C Atzema","year":"2006","journal-title":"Can Fam Physician"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1590\/1516-3180.20151334T1","article-title":"Antiviral treatment for Bell's palsy (idiopathic facial paralysis)","volume":"133","author":"O M Takayanagui","year":"2015","journal-title":"Sao Paulo Med J"},{"issue":"08","key":"ref19","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2310\/7010.2001.16848","article-title":"Should children with Bell's palsy be treated with corticosteroids? A systematic review","volume":"16","author":"M S Salman","year":"2001","journal-title":"J Child Neurol"},{"issue":"04","key":"ref20","first-page":"207","article-title":"The role of functional electrical stimulation in the rehabilitation of patients with incomplete spinal cord injury--observed benefits during gait studies","volume":"31","author":"M H Granat","year":"1993","journal-title":"Paraplegia"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.otohns.2008.04.030","article-title":"Electrical stimulation facilitates rat facial nerve recovery from a crush injury","volume":"139","author":"D Lal","year":"2008","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/S0194-5998(96)70206-1","article-title":"Development of a sensitive clinical facial grading system","volume":"114","author":"B G Ross","year":"1996","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"12","key":"ref23","first-page":"CD006283","article-title":"Physical therapy for Bell's palsy (idiopathic facial paralysis)","author":"L J Teixeira","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/0269215507070790","article-title":"Effect of facial neuromuscular re-education on facial symmetry in patients with Bell's palsy: a randomized controlled trial","volume":"21","author":"N Manikandan","year":"2007","journal-title":"Clin Rehabil"},{"issue":"08","key":"ref25","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1097\/01.mlg.0000225980.38147.c6","article-title":"Multimodality approach to management of the paralyzed face","volume":"116","author":"T A Hadlock","year":"2006","journal-title":"Laryngoscope"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"391","DOI":"10.2522\/ptj.20090176","article-title":"Comprehensive facial rehabilitation improves function in people with facial paralysis: a 5-year experience at the Massachusetts Eye and Ear Infirmary","volume":"90","author":"R W Lindsay","year":"2010","journal-title":"Phys Ther"},{"issue":"08","key":"ref27","doi-asserted-by":"crossref","first-page":"882","DOI":"10.3109\/00016489.2011.577447","article-title":"Combined protocol for treatment of secondary effects from facial nerve palsy","volume":"131","author":"S Monini","year":"2011","journal-title":"Acta Otolaryngol"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/0194599811424125","article-title":"Mirror biofeedback rehabilitation after administration of single-dose botulinum toxin for treatment of facial synkinesis","volume":"146","author":"T Azuma","year":"2012","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1001\/archfaci.10.2.84","article-title":"Botulinum toxin and quality of life in patients with facial paralysis","volume":"10","author":"R P Mehta","year":"2008","journal-title":"Arch Facial Plast Surg"},{"issue":"04","key":"ref30","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1288\/00005537-198504000-00007","article-title":"Idiopathic (Bell's) facial palsy: natural history defies steroid or surgical treatment","volume":"95","author":"M May","year":"1985","journal-title":"Laryngoscope"},{"issue":"02","key":"ref31","first-page":"107","article-title":"The natural history of Bell's palsy","volume":"4","author":"E Peitersen","year":"1982","journal-title":"Am J Otol"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1713808.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T19:58:45Z","timestamp":1723406325000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1713808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,13]]},"references-count":31,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,12,24]]},"published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1713808","relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"value":"0736-6825","type":"print"},{"value":"1098-8793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,13]]}}}