Hyperic
Oxygen Therapy Proves Effective in Bell's Palsy
(Facial Palsy)
Bell's
Palsy is unilateral (one-sided) facial paralysis of sudden onset.
The cause is not known, but there is disturbance of the facial nerve
with swelling during its course in the facial canal leading to compression
and ischemia of the nerve. It resolves spontaneously in 70 - 80
percent of cases, but the recovery may be prolonged and residual
disability and disfigurement may persist. Treatments used include
corticosteroids and surgical decompression of the facial nerve.
Treatment
of Bell's palsy remains controversial. Surgical decompression has
not produced any better outcome than spontaneous resolution of the
palsy. Several prospective and retrospective studies suggest strongly
that corticosteroids are beneficial but no definitive study has
been done to prove the value of corticosteroids.
Litavrin
et al (1985) reported on HBO as a part of multimodal therapy for
Bell's palsy in 42 patients. A further 29 patients with a similar
clinical picture were treated by conventional methods and served
as controls. The authors concluded that the addition of HBO to other
methods increases the efficacy of the treatment, and reduces the
period needed for restoration of the function of the damaged nerve.
Nakata(1986)
treated 66 patients with Bell's palsy using HBO. In 54 patients
for whom the treatment was started within 2 weeks after onset, 45
(83%) recovered completely, 7 recovered partially and 2 did not
recover. All the patients whose EMG showed evidence of neuropraxia
recovered completely. Those with incomplete denervation also recovered,
but their recovery period was much longer. This pattern of recovery
is better than could be predicted from the natural history of the
disease, or as a result of other treatments such as steroids and
surgical decompression.
Racic
et al (1997) compared the therapeutic effects of HBO with those
of prednisone treatment in 79 patients with Bell's palsy who were
randomly assigned either to the HBO treated group (n=42) or to the
prednisone treated group (n=37). The HBO group was exposed to 2.8
ata of 100% oxygen for 60 min. twice a day, 5 days a week and was
given a placebo orally. The prednisone group was exposed to 2.8
ata of 7% O2 (equivalent to 21% O2 in air at normal pressure) following
the same schedule as the HBO group; prednisone was given orally
(total of 450mg in 8 days). Subjects from both groups were treated
in the hyperbaric chamber for up to 30 sessions or to complete recovery
and were followed up for 9 months. At the end of the follow-up period,
95.2% of subjects treated with HBO and 75.7% of subjects treated
with prednisone recovered completely. The average time to complete
the recovery in the HBO group was 22 days as compared to 34.4 days
in the control group (p<0.00l). These results suggest that HBO
is more effective than prednisone in treatment of Bell's palsy.
These
statistics are from the Textbook of Hyperbaric Medicine by K. K.
Jain, 3rd Revised Edition.
HBO
has been proven effective in the treatment of Bell's palsy and in
conjunction with other treatments, helps to prevent permanent facial
disfigurement.
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