Evidence map›Paper›PMID 40365852›Full record

ArticleThe Laryngoscope2025

Initial Treatment and Referral Patterns for Acute Facial Palsy: Insights From Emergency Department Practices.

Christine C Little, Rahul K Sharma, Alexander Barna, Priyesh N Patel, Scott J Stephan, Shiayin F Yang

Abstract read
In one paragraph

Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Christine C LittleDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-9191-0282
Rahul K SharmaDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0003-3120-6194
Alexander BarnaDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-9712-7336
Priyesh N PatelDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Scott J StephanDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Shiayin F YangDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-9889-1363

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate variations in Bell's Palsy treatment and referrals within the Emergency Department (ED), with a focus on sociodemographic and provider-related factors.

methodsA retrospective cohort review was performed including patients with a new diagnosis of Bell's Palsy or acute facial paralysis treated at a single, tertiary academic ED between 2017 and 2024. Management practices, including the use of steroids, antivirals, imaging, specialty consultations, and referrals, were evaluated across sociodemographic variables and provider types. Multivariable logistic regression was used to identify differences in management practices.

resultsThe final cohort comprised 887 patients. Of these, 82.1% received steroids, 57.7% received antivirals, and 57.3% underwent imaging. Hispanic patients were significantly less likely to receive imaging (OR 0.48, p = 0.006), whereas older patients were more likely to undergo imaging (OR 1.04, p < 0.001). Patients with Medicare and Medicaid insurance were less likely to receive bimodal therapy (steroids with antivirals) compared to private insurance holders (OR 0.30, p < 0.001 and OR 0.49, p < 0.001, respectively). Residents and fellows were more likely to obtain specialty consults (OR 2.51, p < 0.001) and imaging (OR 1.42, p = 0.043) than attending physicians. Nearly one third of patients received subspecialty consultation by neurology (26.0%), otolaryngology (6.2%), or plastic surgery (0.2%).

conclusionsDespite increasing awareness regarding the treatment of acute facial palsy, this study reveals existing disparities in initial management by age, insurance status, race, and provider type. Efforts should focus on increasing provider awareness of treatment guidelines to standardize management protocols for improved care delivery and equity. LEVEL OF EVIDENCE: 4:

Indexed as

Bell PalsyEmergency Service, HospitalFacial ParalysisPractice Patterns, Physicians'Referral and ConsultationAcute DiseaseAdolescentAdultAgedAntiviral AgentsChildFemaleHumansMaleMiddle AgedRetrospective StudiesAntiviral Agentsacute facial paralysisbell's palsyclinical practice guidelinesemergency department

Identifiers

PMID40365852
PMCPMC12645349

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.