Bell Palsy

Researchers are evaluating outcomes of facial reanimation surgeries in patients with extensive, permanent, unilateral mid-facial paralysis from various causes. The study aims to compare facial disability and patient perceptions of facial appearance, well-being, and satisfaction among four groups undergoing different types of free gracilis muscle transfer surgeries. The investigation also compares surgeons assessments with objective 3D analyses to determine the usefulness of 3D measures as outcome tools. This prospective observational study includes patients aged 18 to 75 scheduled for facial muscle reconstruction with one of four nerve innervation methods trigeminal nerve graft, cross-face nerve graft, dual innervation, or midfacial modification involving nerve coaptation and selective neurolysis. Participants will be recruited from a single treatment center and followed at three visits before surgery, and at 5 and 18 months after surgery to track changes in facial movement and patient well-being. At each visit, patients complete psychosocial questionnaires assessing the impact of paralysis and recovery, undergo 3D dynamic facial movement recordings, static 3D facial photography, and video recordings of facial animations. Data collected include facial impairment and disfigurement measures, patient-centered quality of life questionnaires, and comparisons of clinical scoring with 3D objective assessments. The total study duration for each participant is 18 months, focusing on long-term surgical outcomes.

This research aims to compare two surgical techniques, anterior and posterior white line advancement, for correcting primary aponeurotic ptosis in adults. The study seeks to determine if the anterior approach improves eyelid position, measured by Marginal Reflex Distance 1 MRD1, better at 6 months than the posterior approach. It also evaluates differences in eyelid symmetry, contour, vision, and patient satisfaction between the two methods. Participants will be randomly assigned to one of two groups one receiving the anterior approach involving a skin crease incision to access and advance the levator aponeurosis, and the other receiving the posterior approach, which uses a conjunctival incision without a skin cut. Both surgeries involve advancing the white line to the anterior tarsus using sutures. The study includes follow-up visits at 7 days, 2 months, and 6 months after surgery. During these visits, researchers will measure eyelid position and symmetry, evaluate eyelid contour using both software and masked evaluators, and test vision and tear film stability. Patients will also complete surveys on dry eye symptoms, scar quality, satisfaction, and psychosocial function. Surgical time and complications will be monitored. All images and data will be securely stored, and outcome assessors will be blinded to the group assignments for certain evaluations.

Bells palsy is a sudden weakness or paralysis on one side of the face that affects facial movement, speech, eating, and emotional well-being. This study evaluates whether combining targeted neural mobilization with proprioceptive neuromuscular facilitation PNF improves facial symmetry and motor function more effectively than PNF alone in patients aged 15 to 60 with moderate to severe Bells palsy. The trial is a randomized controlled study conducted over one year with 36 participants. Participants are assigned by coin toss to either an experimental group receiving neural mobilization plus PNF and conventional therapy or a control group receiving only PNF and conventional therapy. Both groups attend sessions three times per week for four consecutive weeks, with each session lasting 30 to 45 minutes. Neural mobilization involves gentle facial nerve movement within a pain-free range, while PNF uses rhythmic initiation and resisted voluntary movements targeting specific facial muscles. Conventional therapy includes facial exercises with electrical stimulation and daily home exercises with mirror feedback. During the study, participants are assessed at the start and after four weeks using the House-Brackman scale and Sunnybrook facial grading system to measure facial paralysis severity and resting symmetry. Researchers monitor improvements in facial symmetry and motor function through these scales. Data analysis will be conducted using statistical software. The total participation time includes the four-week intervention period with regular assessments to evaluate treatment effects.

This research aims to compare two surgical methods for upper eyelid surgery called blepharoplasty, which removes excess skin that can affect peripheral vision and appearance. The study uses a split-face design where one eyelid undergoes traditional surgery using a blade, cautery, and sutures, while the other eyelid is treated with Ziplyft, a clamp device that compresses the skin to prevent bleeding and uses tissue adhesive instead of sutures. The goal is to evaluate bruising, wound healing, surgery time, and satisfaction from both patients and surgeons. Participants will have one eyelid treated with standard blepharoplasty involving blade removal, blood vessel cautery, and suturing, and the other eyelid treated with Ziplyft which compresses skin to stop bleeding, allowing incision closure with tissue adhesive. Both sides will have equal amounts of skin removed. The surgeon will record the time taken for each procedure. Follow-up photos will be taken at 3, 7 days, and 1 month after surgery to assess bruising and incision healing. During the study, participants will be evaluated with independent professional review of post-operative photos to measure bruising and incision appearance. Both patient and surgeon surveys will capture satisfaction levels up to two months after surgery. The study tracks wound closure success and compares surgical case times. Follow-up visits and evaluations will ensure comprehensive monitoring of outcomes and participant experience.

Skull base tumor surgery is complex because many important nerves and blood vessels are nearby. Researchers are studying how diffusion tensor imaging DTI and tractography, which map nerve fibers, can help predict the location of cranial nerves affected by these tumors. This imaging technique may assist surgeons in avoiding nerve damage during surgery. The study is interventional and evaluates the accuracy of DTI in locating cranial nerves before and after surgery. Participants with skull base tumors needing surgical removal undergo a preoperative cerebral MRI using a 3 tesla machine with a DTI sequence to track cranial nerve fibers. The expected nerve positions from imaging are compared to their actual positions found during surgery. The study focuses on patients requiring tumor removal and uses imaging to support surgical planning. During the study, patients receive a preoperative MRI within three months before surgery. Researchers then assess the correlation between the nerve positions predicted by imaging and those observed during the operation and again three months after surgery. They also monitor for any postoperative cranial nerve palsy at three months. This helps evaluate how well the imaging method predicts nerve location and potential nerve damage over time.

This research aims to compare how different laser wavelengths 808 nm, 980 nm, and 1064 nm affect nerve healing in patients with Bells palsy, a condition causing facial paralysis and movement problems. By studying these laser treatments, researchers hope to improve clinical care, rehabilitation methods, and quality of life for people with this nerve disorder. Participants are randomly assigned to one of four groups a sham laser device group, a Low-Level Laser Therapy group, a gallium arsenide diode laser group, or a high-intensity laser treatment group. Each group receives 18 treatment sessions over six weeks, with three sessions each week. All participants also receive facial muscle massage and exercises to support nerve recovery. During the study, researchers will assess the facial nerve function using compound motor action potential tests at the start and after six weeks of treatment. Other assessments include facial disability scoring and monitoring of therapy sessions. The total study period includes the six-week treatment phase, with safety and progress tracked throughout.

Researchers are investigating the effect of Neuromuscular Electrical Stimulation NMES on improving facial symmetry in people who have central facial palsy caused by stroke. Central facial palsy is a common condition after stroke, affecting about 45% of patients, and can cause facial asymmetry, difficulty closing the mouth, problems with eating, bite marks on the cheek, social isolation, and lower quality of life. This trial aims to compare NMES combined with usual facial palsy training to usual training alone, as there is currently little scientific evidence on the effectiveness of these treatments. Participants will be randomly assigned to one of two groups. One group will receive NMES in addition to their usual care, which includes mimical exercises, facio-oral sensory input, and kinesio taping. The other group will receive the usual care without NMES. The study is designed as a randomized controlled trial with a pilot phase, and participants from the pilot will be included in the main trial. The treatments will be administered over a four-week period. During the study, participants will be assessed using tools such as My Facial Quantification MyFacialQ from enrollment to the end of treatment at four weeks. Additional measurements include the Iowa Oral Performance Instrument and Facial Clinimetric Evaluation, with follow-up lasting up to three months after the intervention. The trial will monitor facial symmetry improvements and functional outcomes related to facial palsy. The entire study period extends to December 2030, allowing for long-term observation and data collection.

Bells palsy is a common facial nerve disorder causing weakness or paralysis on one side of the face. This research evaluates the effects of two treatments, Prednisolone and Cerebrolysin, to study how well Cerebrolysin helps nerve regeneration compared to corticosteroids. The trial is a randomized, double-blind study sponsored by October 6 University, focusing on adults aged 18 to 60 years with acute unilateral facial palsy of unknown cause. Participants will be assigned to one of three treatment groups Prednisolone alone, Cerebrolysin alone, or a combination of both. Prednisolone is given as a 60 mg tablet once daily for 5 days followed by a tapering dose, while Cerebrolysin is administered intramuscularly at 10 mg daily for 3 weeks. The study monitors changes in facial nerve function over three weeks using standardized grading systems. During the study, participants will be assessed at baseline, after 1 week, and after 3 weeks using the House-Brackmann and Sunnybrook grading scales to measure facial nerve recovery. Researchers will track progress and safety throughout the trial period. Total participation time includes initial screening and treatment phases, with follow-up evaluations to measure treatment outcomes and monitor for any complications.

Researchers are evaluating the use of oral cortisone prednisolone treatment in children aged 1 to 17 years who have acute peripheral unilateral facial nerve palsy. This condition affects about 10 to 20 children per 100,000 annually in Sweden, with 20% experiencing lasting symptoms such as excessive tearing, drooling, and facial asymmetry. The study is a double-blind, randomized, placebo-controlled multicenter trial aimed at assessing whether prednisolone improves recovery compared to placebo over 12 months. Participants will be randomly assigned to receive either prednisolone tablets dosed at 1 mg per kg of body weight daily for 10 days up to a maximum of 50 mg per day or placebo tablets that look identical. The treatment will start upon admission, and clinical data will be collected during follow-up visits. The primary outcome is full recovery of facial nerve function measured by the House-Brackmann scale at 12 months, with additional facial function and disability assessments also conducted. During the study, children will undergo clinical evaluations at regular intervals up to 12 months to monitor nerve recovery and facial function using several scales and questionnaires. Researchers will track adherence to treatment and monitor for any side effects or complications. The total participation time for each child will be approximately one year, allowing detailed observation of long-term outcomes and treatment effects.

Peripheral facial palsy affects many people and can cause involuntary facial spasms called synkinesis, which disrupt facial movement and may cause painful muscle tightness. Over half of patients recovering from facial palsy develop synkinesis, which does not improve on its own. This condition results from nerve damage and increased nerve excitability, making effective management important for facial function restoration. Treatments currently include botulinum toxin injections and muscle relaxation exercises, while new approaches using biofeedback and virtual reality show promise in improving motor control. This trial evaluates the use of virtual reality self-rehabilitation for patients with peripheral facial palsy. Participants are randomly assigned to receive either rehabilitation combined with virtual reality, where they watch an avatar mimicking facial movements and imagine performing them, or rehabilitation without virtual reality. The rehabilitation includes massages, motor stimulation, and stretching exercises. The study aims to assess if virtual reality enhances motor control and reduces complications such as synkinesis. Participants are monitored over 12 months, during which the number of involuntary facial spasms is measured to compare the two groups. The study includes adult patients with recent onset facial palsy of a certain severity. Assessments focus on facial muscle control and spasm frequency. The research is supported by the Centre Hospitalier Universitaire, Amiens, and runs from August 2022 through August 2029, aiming to support care improvements for facial palsy patients.