Effect of Direct Facial Nerve Neuromodulation Under Ultrasound Guide in Functional Recovery of Bell's Palsy

Abstract

Background: Neuromodulation is the alteration of neuronal and synaptic properties by neurons
themselves or by substances released by neurons.
Objective: To evaluate the effectiveness and safety of peripheral nerve stimulation and pulse
radiofrequency in the management of Bell's palsy.
Patients and methods: A clinical therapeutic trial study was conducted in Al Arabi Private Hospital, Iraq
during the period from the 1st of January to the 1st of December 2023. A convenient sample of 50
patients who presented with unilateral Bell's palsy were enrolled. Inclusion criteria included patients
aged≥18 years and those who did not respond to medical conservative therapy. The intervention
included sensory nerve stimuli, motor nerve stimuli, and pulse radiofrequency for two sessions at threemonth intervals.
Results: There was a notable enhancement in facial symmetry during periods of rest, voluntary
movements, synkinesis, and sensory impairment following the initial session, as well as after the second
session in comparison to the first session. The first session resulted in a notable reduction in the
percentage of patients exhibiting normal facial expressions and those experiencing mild paralysis, as
compared to their pre-intervention condition. Following the second session, there was a notable rise in
the percentage of patients exhibiting normal facial expressions in comparison to the initial session.
Conclusion: Sensory stimulation, motor stimulation, and pulse radiofrequency are viable and secure
methods for managing patients with Bell's palsy