Diagnosis

Document Overview

Design and created by Guideline Central in participation with the American Academy of Otolaryngology - Head and Neck Surgery Foundation.

Bell’s Palsy

American Academy of Otolaryngology - Head and Neck Surgery Foundation

Publication Date: Nov 3, 2013

Page Last Updated: May 5, 2026

Evidence Quality and Recommendation Grades

Evidence Quality and Recommendation Grades^a
Evidence Quality			Recommendation
Treatment and Harm	Diagnosis	Strength
A	High-quality RCTs	Systematic review of consistent cross-sectional studies	S	Strong recommendation
B	Consistent RCTs	Consistent individual cross-sectional studies	R	Recommendation
C	Observational studies	Nonconsecutive studies, case-control studies, or other studies of poor quality	O	Option
D	Case reports, consensus opinions		N	None
X	Exceptional situations with clear benefit		X

^a See full text guidelines for details.

Document Overview

Document Title: Bell’s Palsy

Authoring Society: American Academy of Otolaryngology - Head and Neck Surgery Foundation

Document Publication Date: Nov 3, 2013

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599813505967

Source Citation: Baugh RF, Basura GJ, Ishii LE, et al. Clinical Practice Guideline: Bell’s Palsy. Otolaryngology–Head and Neck Surgery. 2013;149(3_suppl):S1-S27. doi:10.1177/0194599813505967

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell's palsy, to improve the quality of care and outcomes for patients with Bell's palsy, and to decrease harmful variations in the evaluation and management of Bell's palsy. This guideline addresses these needs by encouraging accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell's palsy.

Scope: Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D020330 - Bell Palsy

Keywords: Bell’s palsy, facial nerve disorder, idiopathic facial nerve paralysis

Target Patient Population: adults and children presenting with Bell’s palsy

Target Provider Population: all clinicians in any setting who are likely to diagnose and manage patients with Bell’s palsy

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory, Emergency Care

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 148

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Bell’s Palsy

Diagnosis

Treatment

Table 4. Summary of Guideline Action Statements

Diagnostics

Patient history and physical examination

Laboratory testing

Diagnostic imaging

Electrodiagnostic Testing

With incomplete paresis/paralysis

With complete paresis/paralysis

Treatment

Steroids

Oral steroid use

Antiviral Therapy

Monotherapy

Combination

Other

Eye care

Surgical decompression

Acupuncture

Physical therapy

Patient Follow-up

Evidence Quality and Recommendation Grades

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology