(1) Glucocorticoid can reduce the inflammatory reaction and swelling of the facial nerve in acute stage, and make it compressed in the facial nerve canal with a fixed diameter, thus reducing the degree of facial nerve compression by the facial nerve canal and microcirculation disturbance caused by edema and thickening. Therefore, glucocorticoid therapy is the first choice and the main drug treatment for this disease. It can also effectively relieve pain. Pay attention to diabetes, tuberculosis, gastric ulcer and pregnant women with caution. Patients with hypertension should pay attention to controlling blood pressure.
(2) Antiviral drugs can interfere with herpes virus DNA polymerase and inhibit DNA replication. Acyclovir is commonly used, and ganciclovir, famciclovir or valaciclovir can also be used. Acyclovir ointment is used externally for ear and peripheral herpes, 1 ~ 3 times a day, which can control local virus replication, promote scab shedding of herpes and promote local damaged skin healing.
(3) intramuscular injection or oral administration of neurotrophic drugs such as vitamin B 1 and vitamin B 12.
(4) The drugs for improving facial nerve microcirculation are intravenous injection or oral administration of Ginkgo biloba extract or other drugs for dilating blood vessels and improving microcirculation.
(5) Painkillers can be used appropriately when the ear is in severe pain.
(6) Anti-vertigo drugs such as tea Benjamin and diazepam can be used to relieve dizziness.
(7) Eye ointment and eye drops At night, you can apply eye ointment, such as tetracycline or erythromycin eye ointment, to protect your eyes with an eye patch. Artificial tears can be used when the tears are reduced.
2. Surgical therapy
(1) facial nerve decompression showed that the degeneration number of facial nerve fibers reached 90% ~ 94%. When it is found that the facial nerve function has not improved and gradually deteriorated, facial nerve decompression should be carried out in time.
(2) Eye Surgery For patients with long-term facial paralysis or permanent complete facial paralysis, eyelid surgery, suspension surgery and eye plastic surgery are needed to prevent or treat eye complications. Upper eyelid gold plate implantation is a common operation to help close eyelids. Temporary suture of upper and lower eyelids is an effective method to prevent and treat corneal ulcer.
(3) facial plastic surgery When facial paralysis is complete and permanent with facial muscle atrophy, facial plastic surgery can be used. Including the suspension of facial skin, subcutaneous tissue and muscles to restore the asymmetry of the face at rest and the operation of pulling the orbicularis oculi and orbicularis oris muscles by using other facial peripheral muscle activities other than the expression muscles. These include fascia suspension, aponeurosis suspension, temporal muscle flap transfer and masticatory muscle flap transfer.
3. Other treatments
(1) Traditional Chinese medicine and acupuncture can play an auxiliary role. Acute phase (1 ~ 2 weeks) is not suitable for strong stimulation such as acupuncture, but acupuncture can be used after acute phase. Traditional Chinese medicine drugs for promoting blood circulation and removing blood stasis have an auxiliary effect on improving facial nerve microcirculation. Chinese medicine for clearing away heat and toxic materials can also be used to resist viruses.
(2) Hot compress, physical therapy, facial massage, etc. In the acute stage, adjuvant therapies such as hyperthermia, magnetic therapy or electromagnetic therapy, ultrashort wave or microwave, laser and direct current drug iontophoresis can be used. Physical therapy such as muscle massage and training can be used in the recovery period. Patients with hemifacial spasm can be treated with magnesium iontophoresis and injection of phenol solution, botulinum toxin and other spasmodic muscle movement point blocking therapy.