Facial palsy: what can the multidisciplinary team do?

Butler, Daniel P.; Grobbelaar, Adriaan O.

doi:10.2147/jmdh.s125574

Cited by 28 publications

(29 citation statements)

References 46 publications

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“…We refer the reader to specific reviews about multidisciplinary treatment and rehabilitation of facial palsy and lower cranial nerve deficits as possible complications of surgical therapy. [159][160][161]…”

Section: Supportive Carementioning

confidence: 99%

EANO guideline on the diagnosis and treatment of vestibular schwannoma

Goldbrunner

Weller

Régis³

et al. 2019

Neuro-Oncology

250

227

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The level of evidence to provide treatment recommendations for vestibular schwannoma is low compared with other intracranial neoplasms. Therefore, the vestibular schwannoma task force of the European Association of Neuro-Oncology assessed the data available in the literature and composed a set of recommendations for health care professionals. The radiological diagnosis of vestibular schwannoma is made by magnetic resonance imaging. Histological verification of the diagnosis is not always required. Current treatment options include observation, surgical resection, fractionated radiotherapy, and radiosurgery. The choice of treatment depends on clinical presentation, tumor size, and expertise of the treating center. In small tumors, observation has to be weighed against radiosurgery, in large tumors surgical decompression is mandatory, potentially followed by fractionated radiotherapy or radiosurgery. Except for bevacizumab in neurofibromatosis type 2, there is no role for pharmacotherapy.

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Section: Supportive Carementioning

confidence: 99%

EANO guideline on the diagnosis and treatment of vestibular schwannoma

Goldbrunner

Weller

Régis³

et al. 2019

Neuro-Oncology

250

227

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“…Interestingly, reports are now emerging of efforts to integrate physical therapy with treatment by ophthalmologists, oculoplastic surgeons, and ENT and other specialists [ 51 ]. It is also considered that MDTs are likely to play an important role in standardizing outcome measures and implementing relevant data collection [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Raising the Digital Profile of Facial Palsy: National Surveys of Patients’ and Clinicians’ Experiences of Changing UK Treatment Pathways and Views on the Future Role of Digital Technology

Szczepura¹,

Holliday²,

Neville³

et al. 2020

J Med Internet Res

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Background Facial nerve palsy leaves people unable to move muscles on the affected side of their face. Challenges exist in patients accessing facial neuromuscular retraining (NMR), a therapy used to strengthen muscle and improve nerve function. Access to therapy could potentially be improved through the use of digital technology. However, there is limited research available on patients’ and clinicians’ views about the potential benefits of such telerehabilitation based on their lived experiences of treatment pathways. Objective This study aims to gather information about facial palsy treatment pathways in the United Kingdom, barriers to accessing NMR, factors influencing patient adherence, measures used to monitor recovery, and the potential value of emerging wearable digital technology. Methods Separate surveys of patients with facial palsy and facial therapy specialists were conducted. Questionnaires explored treatment pathways and views on telerehabilitation, were co-designed with users, and followed a similar format to enable cross-referencing of responses. A follow-up survey of national specialists investigated methods used to monitor recovery in greater detail. Analysis of quantitative data was conducted allowing for data distribution. Open-text responses were analyzed using thematic content analysis. Results A total of 216 patients with facial palsy and 25 specialist therapists completed the national surveys. Significant variations were observed in individual treatment pathways. Patients reported an average of 3.27 (SD 1.60) different treatments provided by various specialists, but multidisciplinary team reviews were rare. For patients diagnosed most recently, there was evidence of more rapid initial prescribing of corticosteroids (prednisolone) and earlier referral for NMR therapy. Barriers to NMR referral included difficulties accessing funding, shortage of specialist therapists, and limited awareness of NMR among general practitioners. Patients traveled long distances to reach an NMR specialist center; 9% (8/93) of adults reported traveling ≥115 miles. The thematic content analysis demonstrates positive attitudes to the introduction of digital technology, with similar incentives and barriers identified by both patients and clinicians. The follow-up survey of 28 specialists uncovered variations in the measures currently used to monitor recovery and no agreed definitions of a clinically significant change for any of these. The main barriers to NMR adherence identified by patients and therapists could all be addressed by using suitable real-time digital technology. Conclusions The study findings provide valuable information on facial palsy treatment pathways and views on the future introduction of digital technology. Possible ways in which emerging sensor-based digital technology can improve rehabilitation and provide more rigorous evidence on effectiveness are described. It is suggested that one legacy of the COVID-19 pandemic will be lower organizational barriers to this introduction of digital technology to assist NMR delivery, especially if cost-effectiveness can be demonstrated.

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“…Referat as a non-invasive therapy approach is recommended for patients with facial nerve palsy of various origins and comprises functional motor exercises for the reactivation of the mimic muscles in the sense of a neuromuscular training. The currently available studies show that a well-structured therapy within the framework of an interdisciplinary concept may achieve good therapeutic results contributing to avoid synkinesis or hyperkinesis [91][92][93][94]. Currently available instruction forms revealed a high need for improvement, since the visual control by using a mirror is from our experience associated with a low compliance.…”

Section: Tinnitusmentioning

confidence: 99%

Medizinische Apps in der HNO-Heilkunde

Rak¹,

Völker²,

Taeger³

et al. 2019

Laryngo-Rhino-Otol

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ZUsAmmenfAssUng Die Nutzung mobiler Informations-und Kommunikationstechnologie im Kontext medizinscher und gesundheitsnaher Dienstleistungen, z. B. in Form von Apps, gewinnt, leider jedoch häufig unter Missachtung notwendiger Qualitätskriterien, immer mehr an Bedeutung. So erscheint es wichtig, dass neben einer die Anwendungssoftware kontrollierenden Instanz möglichst hoch qualifizierte Akteure des Gesundheitswesens bei der Erstellung mitwirken. Schon aus Haftungsgründen muss der beratende Arzt eine hohe Sorgfalt bei der Auswahl und Empfehlung einer App walten lassen, gerade auch in Anbetracht der Tatsache, dass nur wenige Apps als Medizinprodukt zertifiziert sind. Auf dem Markt gibt es eine große Anzahl an medizinischen Apps, wobei nur ein geringer Anteil dieser auf den Fachbereich HNO-Heilkunde entfällt. Prozentual sind die Teilbereiche Audiologie, Schlafmedizin und Allergologie am häufigsten vertreten. Obwohl sich der Fachbereich der HNO-Heilkunde zunehmend mit dieser Thematik wissenschaftlich auseinandersetzt, fehlt, wie generell bei vielen medizinischen Apps, eine wissenschaftliche Evidenz der Inhalte und Ergebnisse. Es gibt jedoch für Anwender weitere Möglichkeiten, medizinische Apps nach definierten Qualitätskriterien in verschiedenen Kategorien, wie z. B. Funktionalität, Wissenschaftlichkeit, aber auch Datenschutz, zu beurteilen. Keine der mittels eines solchen Bewertungstools evaluierten Apps erfüllte alle geforderten Kriterien, dem Anwender steht jedoch hiermit ein Instrument zur besseren Einschätzung der Anwendungssoftware zur Verfügung. Im Rahmen des Entwicklungsprozesses einer medizinischen App für den HNO-Bereich war es jedoch möglich, die Qualitätskriterien zu berücksichtigen. Zusammenfassend soll die vorliegende Arbeit einen Überblick über Thema "Apps in der HNO-Heilkunde" ermöglichen mit dem Ziel, dieses moderne Hilfsmittel nutzbringend einsetzen zu können. ABsTRAcTThe implementation of mobile information and communication technology in the field of health services, e. g. in the form of apps, is becoming increasingly important. Unfortunately, the necessary quality criteria are often mising. Thus, it seems important, that in addition to an app controlling authority highly qualified health care professionals participate in the development of these applications. For reasons of liability, however, the physician must exercise great caution in the selection and recommendation of medical apps, especially considering, that only a few apps are certified as medical devices. There are a large number of medical apps on the market, with only a small proportion being assigned to the field of otorhinolaryngology. The areas of audiology, sleep medicine and allergology are most frequently represented. Althouhgh there is increasing scientific work on this topic in the field of otorhinolaryngology, there is a lack of scientific evidence of contents and results, as is generally the case of medical apps.However, there are other possibilities for users to rate medical apps regarding defined qualitiy criteria such as f...

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Facial palsy: what can the multidisciplinary team do?

Cited by 28 publications

References 46 publications

EANO guideline on the diagnosis and treatment of vestibular schwannoma

EANO guideline on the diagnosis and treatment of vestibular schwannoma

Raising the Digital Profile of Facial Palsy: National Surveys of Patients’ and Clinicians’ Experiences of Changing UK Treatment Pathways and Views on the Future Role of Digital Technology

Medizinische Apps in der HNO-Heilkunde

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