Holland
Systematic review suggests some evidence that HBOT improves the rate of recovery in Bell’s Palsy
- Citation:
Holland NJ, Bernstein JM, Hamilton JW. Hyperbaric oxygen therapy for Bell's palsy. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD007288.
- CLINICAL BOTTOM LINE:
Hyperbaric oxygen may improve the rate of recovery of facial palsy in moderate to severe Bell’s palsy when compared with prednisone.
- Clinical scenario:
A patient presents with a 5 day history of significant unilateral facial weakness from Bell’s palsy.
- Three part question:
In patients with Bell’s palsy, does hyperbaric oxygen therapy improve recovery of facial nerve palsy.
- The Study
Cochrane review (meta-analysis). Identified only one trial that was close to meeting eligibility criteria: Randomised, single blinded control trial
- The patients: moderate to severe Bell’s Palsy within 2 weeks of onset
Control group: (N= 37, 37 analysed) Prednisone (commencing at 40mg, weaning dose) with HBO at 2.8 atm and FiO2 0.21) Experimental group: (N = 42, 42 analysed) HBO at 2.8 atm and placebo tablets
- The Evidence
See Racic 2007 (single study discussed here)
| Outcome | Time to outcome | Control | Treatment | Absolute risk reduction | Relative risk reduction | NNT |
| Improvement in Facial Nerve palsy | 9 months | 0.76 | 0.95 | 0.19 | 1.26 1.04 to 1.53 |
5 |
- Comment
1. Observers of outcome were not blinded to treatment group ‘in practice’ (personal communication with Racic). 2. Small number of patients enrolled. 3. No study met eligibility criteria. Racic was excluded because outcome assessor was not blinded to allocation. 4. Authors rate Racic study as producing ‘very low quality evidence’
- Reviewed by
Dr Danielle Wood MBBS, FACEM, Visiting Medical Officer in Hyperbaric medicine Correspondence to [| danspace@gmail.com]
Update: June 2020
