Procedural-Based Contemporary Management of Bell's Palsy Long-Term Sequelae: A Narrative Review.

[OBJECTIVE] To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical findings and available interventions.

[DATA SOURCES] PubMed.

[REVIEW METHODS] A literature search was performed on December 18, 2024, via PubMed using keywords such as "synkinesis," "selective myectomy," "selective neurectomy," "botulinum toxin," "intervention" in the context of "Bell's palsy" with preference for articles published within the last 5 to 10 years but inclusion of select older articles that provided necessary context for the current topic. Articles included in the review were written in English or had available English translations and preference was given to meta-analysis and systematic review articles but included randomized control prospective clinical trials.

[CONCLUSIONS] Management of long-term Bell's palsy sequelae requires a multidisciplinary approach, with facial nerve specialists at the helm, offering procedural interventions aimed at restoring facial symmetry and improving a patient's quality of life. General practitioners should be aware of all available treatment options and promptly refer patients with persistent disease or those who develop long-term sequelae.

[IMPLICATIONS FOR PRACTICE] This review may help patients suffering from long-term Bell's palsy sequelae get earlier referrals to facial nerve specialists. General providers will be more aware of the specific signs and symptoms to monitor for in a Bell's palsy patient that warrant referral. Additionally, increased familiarity with available treatment options promotes informed counseling to patients on their disease course.