Hyperbaric Oxygen Therapy in the Management of Bell's Palsy: A Case Study

Objectives: Bell's palsy (BP) is an acute, unilateral facial nerve paralysis that can lead to significant facial muscle dysfunction and considerable impact on quality of life. Standard treatment includes corticosteroids and antiviral medications, but some patients experience incomplete recovery. Hyperbaric oxygen therapy (HBOT) has been proposed as a complementary treatment due to its neuroregenerative and anti-inflammatory properties. Case Presentation: A healthy 31-year-old male presented with acute right-sided facial pain, numbness and muscle weakness, consistent with BP (Grade IV House-Brackmann classification). Diagnostic evaluations, including magnetic resonance imaging and electroneuromyography (ENMG), confirmed the diagnosis. Initial treatment involved prednisone and vitamin B complexes. The patient then underwent HBOT (2.5 ATA, 80 minutes daily, over 18 sessions). Significant clinical improvements were observed following HBOT, with recovery in facial muscle function and reduction of symptoms. Follow-up ENMG showed restoration of nerve conduction. At a 12-month evaluation, the patient achieved near-complete recovery, classified as Grade I on the House-Brackmann scale. Conclusion: This case highlights the potential benefits of integrating HBOT with conventional therapy for BP, suggesting its role in enhancing neuroregeneration and accelerating recovery. Beyond individual outcomes, this case underscores the broader implications of utilising HBOT as an adjunct in conditions with acute nerve injury. Although limited by a paucity of high-quality evidence, HBOT holds promise as a valuable addition to BP management, particularly in cases where conventional treatment yields suboptimal results. These findings warrant further clinical trials to establish its efficacy, optimise protocols and ensure cost-effectiveness for broader implementation.