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Guidelines

Management of Bell palsy: clinical practice guideline

John R. de Almeida, Gordon H. Guyatt, Sachin Sud, Joanne Dorion, Michael D. Hill, Michael R. Kolber, Jane Lea, Sylvia Loong Reg, Balvinder K. Somogyi, Brian D. Westerberg, Chris White, Joseph M. Chen and Bell Palsy Working Group, Canadian Society of Otolaryngology – Head and Neck Surgery and Canadian Neurological Sciences Federation
CMAJ September 02, 2014 186 (12) 917-922; DOI: https://doi.org/10.1503/cmaj.131801
John R. de Almeida
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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  • For correspondence: john.dealmeida@utoronto.ca
Gordon H. Guyatt
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Sachin Sud
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Joanne Dorion
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Michael D. Hill
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Michael R. Kolber
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Jane Lea
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Sylvia Loong Reg
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Balvinder K. Somogyi
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Brian D. Westerberg
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Chris White
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Joseph M. Chen
Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
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Article Information

vol. 186 no. 12 917-922
DOI 
https://doi.org/10.1503/cmaj.131801
PubMed 
24934895
History 
  • Published online September 2, 2014.

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  • Latest version (June 16, 2014 - 08:08).
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Copyright & Usage 
© 2014 Canadian Medical Association or its licensors

Author Information

  1. John R. de Almeida, MD MSc⇑,
  2. Gordon H. Guyatt, MD MSc,
  3. Sachin Sud, MD MSc,
  4. Joanne Dorion, PT BScPT,
  5. Michael D. Hill, MD,
  6. Michael R. Kolber, MD MSc,
  7. Jane Lea, MD,
  8. Sylvia Loong Reg, PT,
  9. Balvinder K. Somogyi, BSW,
  10. Brian D. Westerberg, MD MHSc,
  11. Chris White, MD,
  12. Joseph M. Chen, MD,
  13. Bell Palsy Working Group, Canadian Society of Otolaryngology – Head and Neck Surgery and Canadian Neurological Sciences Federation
  1. Department of Otolaryngology, Head and Neck Surgery (de Almeida), Princess Margaret Hospital, University of Toronto, Toronto, Ont.; Department of Medicine (Guyatt), McMaster University, Hamilton, Ont.; Institute for Better Health and Division of Critical Care (Sud), Department of Medicine, Trillium Health Partners, University of Toronto, Mississauga, Ont.; Facial Rehabilitation (Dorion) and Department of Otolaryngology Head and Neck Surgery (Chen), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Clinical Neurosciences, Hotchkiss Brain Institute (Hill), and Department of Clinical Neurosciences, Faculty of Medicine (White), University of Calgary, Calgary, Alta.; Department of Family Medicine (Kolber), University of Alberta, Peace River, Alta.; Department of Surgery (Lea, Westerberg), Division of Otolaryngology – Head and Neck Surgery, University of British Columbia, Vancouver, BC; St. Paul’s Rotary Hearing Clinic (Lea, Westerberg), Vancouver, BC; Back in Action Physiotherapy (Loong), Markham, Ont.; patient with Bell palsy (Somogyi), Toronto, Ont.; Division of Otolaryngology – Head and Neck Surgery, University of Toronto (Chen), Toronto, Ont.
  1. Correspondence to: John de Almeida, john.dealmeida{at}utoronto.ca

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Canadian Medical Association Journal: 186 (12)
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Management of Bell palsy: clinical practice guideline
John R. de Almeida, Gordon H. Guyatt, Sachin Sud, Joanne Dorion, Michael D. Hill, Michael R. Kolber, Jane Lea, Sylvia Loong Reg, Balvinder K. Somogyi, Brian D. Westerberg, Chris White, Joseph M. Chen, Bell Palsy Working Group, Canadian Society of Otolaryngology – Head and Neck Surgery and Canadian Neurological Sciences Federation
CMAJ Sep 2014, 186 (12) 917-922; DOI: 10.1503/cmaj.131801

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Management of Bell palsy: clinical practice guideline
John R. de Almeida, Gordon H. Guyatt, Sachin Sud, Joanne Dorion, Michael D. Hill, Michael R. Kolber, Jane Lea, Sylvia Loong Reg, Balvinder K. Somogyi, Brian D. Westerberg, Chris White, Joseph M. Chen, Bell Palsy Working Group, Canadian Society of Otolaryngology – Head and Neck Surgery and Canadian Neurological Sciences Federation
CMAJ Sep 2014, 186 (12) 917-922; DOI: 10.1503/cmaj.131801
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