A critical analysis of current trends in the management of Bell's palsy.

The treatment of Bell's palsy has been a controversial subject for many years. During the past 10 years 152 papers pertaining to this affection of the facial nerve have apperaed in the American literature. Ninety-seven of these were general discussions of the etiology, pathology, prognosis and treatment of this condition: 20 were concerned with ascertaining the status of the facial nerve by electrical tests and four with the activity of the chorda tympani nerve in patients with Bell's palsy. The remaining 31 articles specifically discussed the treatment of Bell's palsy. As a result of this obvious interest in Bell's palsy, one would expect that the treatment of this affection of the facial nerve would be more or less uniform at this time. This is not the case, however, for the literature demonstrates it to be in a state of flux. Although steroid therapy has replaced other regimens of medical therapy to a large extent, surgical intervention still has its proponents. It is interesting to note that at the time of this review of the literature, no report of a controlled, double-blind study of the efficacy of steroid therapy for Bell's palsy has appeared in the American literature.