Hyperbaric Oxygenation Therapy For Peripheral Facial Paralysis:a Systematic Review

Background:Peripheral facial paralysis is a kind of common diseases in the department of neurology.The traditional therapeutic methods of peripheral facial paralysis such as medication,acupuncture and physical therapy has already accumulated a lot of effective experience. With the development of the hyperbaric oxygenation therapy,more and more patients with peripheral facial paralysis can reach shorter cure time and have fewer sequelae through HBOT with traditional therapeutic methods.Objective:To evaluate the efficacy and security of hyperbaric oxygenation therapy for peripheral facial paralysis and to make a objective assessment in the way of evidences based all published randomized controlled trials(RCTs) or quasi RCTs.Methods:Formulate the inclusion criteria of peripheral facial paralysis of three common causes.Trials were located through electronic searches of Cochrane library controlled clinical trials database (CCTR),Medline,EMbase,CBM,CNKI,VIP and WANFANG database.Randomized controlled trials(RCT)and semi-randomized controlled trials of clinical studies on hyperbaric oxygenation therapy for peripheral facial paralysis were included.The valid data were used to make Meta-analysis through Revman5.2.software.Results:20 trials,involving 2457 patients,were included in the Meta-analysis. This Meta-analysis researched separately about clinical efficacy rate,cure rate, cure time and Portmann Score.The results were as follows.The total effective rate of the peripheral facial paralysis of three common causes in HBO group was better than that in control group,RR= 1.22,95%CI(1.15, 1.30), P<0.00001, with statistical significance.The total effective rate of the Bell’s palsy and the facial paralysis after mechanical damage in HBO groups were better than those in control groups.The RR and 95%CI were respectively RR= 1.24,95%CI(1.13,1.36),P<0.0001 and RR= 1.17,95%CI(1.09,1.27),P< 0.0001,with statistical significance.The cure rate, average cure time and change of the Portmann score of Bell’s palsy in HBO groups were better than those in control groups.The RR and 95%CI were respectively RR=1.53,95%CI(1.38,1.68),P< 0.00001;RR=8.44,95%CI(6.21,10.68),P<0.00001and RR=5.63,95%CI(4.16,7.10),P<0.00001.with statistical significance. There was no serious adverse reaction in hyperbaric oxygenation therapy for peripheral facial paralysis.Conclusion:The total effective rate,cure rate and average cure time of hyperbaric oxygenation therapy with traditional therapeutic methods for the peripheral facial paralysis of three common causes were better than those of traditional therapeutic methods.HBOT is safe for patients.But the relevant trials are less now.The evidence is not strong enough.due to the low quality trials and the publication bias by funnel plot.So further good quality,large-sample and multi-center RCTs are needed to assess the reliable efficacy of hyperbaric oxygenation therapy for peripheral facial paralysis.