Video consultation in the diagnosis and therapy of patients with facial palsy

Abstract

Introduction Telemedicine can reduce poor health care access and improve the diagnosis and treatment of rare diseases. COVID-19 has also helped telemedicine to become more widely used in Germany. Since April 2020, the Facial Nerve Center Jena also offers virtual consultation hours. Material and Methods We analyzed in retrospect all initial encounters of patients with the Facial Nerve Center Jena between April 2020 and October 2021. 33 patients (20 f, 13 m) aged 9 to 69 years (median: 42) were treated. Results In 28 of 33 cases, a diagnosis of facial palsy was made at initial presentation (duration of paresis: 1 - 512 months, median: 11.5 months), 20 of which showed defect healing and synkinesis. In 4 cases, there was no evidence of facial palsy and further diagnostics were recommended. In one patient, a definite diagnosis could not be made due to technical problems with video transmission. Psychoeducation was given to 28 patients. 20 patients were counseled about a possible injection of botulinum toxin to reduce synkinesis. In 10 cases, we gave recommendation and instruction on corneal protection. Day-care treatment was indicated in 16 patients, and telemedicine biofeedback training was indicated in 8. Travel distances would have ranged from 40 to 1570 km (median: 360 km). Discussion Telemedicine is well suited for diagnosis and therapy of facial nerve palsies and subsequent defect healing, in part, because webcams are optimized to display faces. We see potential in video consultations to provide highly specialized care nationwide, to minimize travel distances, and to simplify second opinion consultations.