Ottavi Alice, Cozzi Anna, Allevi Fabiana, Calvo-Henriquez Christian, Chiesa-Estomba Carlos, Felisati Giovanni, Lechien Jerome R, Maniaci Antonino, Mayo-Yáñez Miguel, Pecorari Giancarlo, Riva Giuseppe, Vaira Luigi Angelo, Saibene Alberto Maria, Urbanelli Anastasia
Otorhinolaryngology Unit, Department of Health Sciences, Santi Paolo e Carlo Hospital, University of Milan, Milan, Italy.
Maxillofacial Surgery Unit, Department of Health Sciences, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy.
Eur Arch Otorhinolaryngol. 2025 Sep;282(9):4443-4454. doi: 10.1007/s00405-025-09367-z. Epub 2025 Apr 26.
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.
We reviewed eligible articles for patient demographics, pre-treatment assessment, parameters of selected treatment, type of treatment, outcomes, and post-treatment assessment.
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.
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.
创伤是面神经麻痹的常见病因，占所有病例的3%。虽然许多面神经麻痹通过药物治疗可痊愈，但有些则需要手术干预。本系统评价旨在确定创伤性面神经麻痹的最佳治疗策略。
我们查阅了符合条件的文章，内容包括患者人口统计学、治疗前评估、所选治疗的参数、治疗类型、结果及治疗后评估。
在135篇独特的文献中，32项研究被认为符合条件，报告了2079例患者的治疗数据。大多数研究（n = 30）为病例系列研究。主要提出的治疗策略为药物治疗、手术治疗或两者结合。对于几乎所有所选研究，均采用House-Brackmann（HB）量表评估面神经麻痹的严重程度。
基于现有文献，由于可用治疗选择的极端异质性以及缺乏标准化的患者分层，创伤性面神经麻痹的标准化治疗指南尚未明确界定。
