Abstracts presented at the South West ENT Academic Meeting 2017, Bath, UK

Abstract

s presented at the South West ENT Academic Meeting 2017, Bath, UK Management of patients with unilateral facial nerve palsy in the acute setting at Royal United Hospital, Bath V Evans, A Henderson, S Gillett From the Royal United Hospital, Bath Introduction The inability to move facial muscles caused by unilateral lower motor neuron facial nerve palsy can have both a significant physical and psychological impact. Acute presentation may be to one of several different medical specialties. Objectives We aimed to: assess the quality of investigation and management of patients with acute lower motor neuron facial nerve palsy, compare with current national guidance, and determine whether ENT assessment changes the outcome. Methods A retrospective notes analysis was conducted of all patients presenting to the emergency department, medical assessment unit and medical ambulatory care with unilateral lower motor neuron facial nerve palsy during a six-month period (1 September 2016 to 1 March 2017). Parameters of measurement included: initial ENT assessment, clinical examination, further imaging, administration of steroids, antivirals and eye protection, and appropriate follow up. Results Of a total of 17 patients, only 5 were seen by ENT. Of those, 100 per cent underwent otoscopy and 80 per cent parotid examination, compared with 0 per cent and 8.33 per cent respectively for the remaining cohort. Of the total patients, 64.7 per cent underwent imaging (most commonly computed tomography of the head – 47.1 per cent). Eighty-two per cent of patients received steroids appropriately, within 72 hours in all cases. Thirty-five per cent of patients received acyclovir (all within 72 hours), but only one patient was examined with otoscopy (by ENT). One hundred per cent of those patients seen by ENT were given eye protection, compared with 58.3 per cent of the remaining patients. Eighty per cent of those seen by ENT were followed up in the outpatient department, compared with 25 per cent of the remainder.