Emerging Medications in Facial Nerve Recovery: A Systematic Review and Meta‐Analysis
Kimberly Chan, Cheng Ma, Bao Y. Sciscent, Andreacarola Urso, Neerav Goyal, Jessyka G. LighthallAbstract
Objective
To systematically review the literature for medical therapies that promote facial nerve regeneration and recovery.
Data Sources
PubMed/Medline, Embase, and SCOPUS databases were searched for English‐language studies published from inception through May 2025.
Review Methods
Human studies evaluating the efficacy of medical therapy on facial nerve regeneration using validated facial nerve grading scales were included.
Results
Nine studies were included in qualitative analysis, and 6 were included in a meta‐analysis. Treatments included nimodipine (n = 6), pentoxifylline (n = 1), co‐enzyme Q10 (n = 1), and extracellular vesicles (n = 1). All studies used HB score, and recovery was defined as HB score ≤3. Recovery was observed in 94% (95% CI:[90%, 97%]) of patients treated with nimodipine and 84% (95% CI: [70%, 97%]) of control patients; this was not statistically significant (OR 2.26, 95% CI: [0.97, 5.26]). Nimodipine significantly decreased HB score by 1.66 (95% CI: [0.81, 2.52]) before and after treatment. Pentoxifylline and extracellular vesicles demonstrated some efficacy, while co‐enzyme Q10 was not efficacious.
Conclusion
Nimodipine improved HB score but was not significantly associated with recovery to HB score ≤3 compared to controls. Pentoxifylline and extracellular vesicles may have some efficacy, but co‐enzyme Q10 is not effective. Further research is required to uncover additional treatments.