A recent study has uncovered the overutilization of diagnostic imaging in the management of Bell’s palsy, a condition that leads to sudden weakness in facial muscles, typically on one side. Although imaging can play a role in ruling out serious underlying conditions, the research suggests it is often conducted when not clinically indicated. The findings, published in The Laryngoscope, aim to refine patient care practices and reduce unnecessary healthcare costs.
This study represents the first nationwide analysis of imaging utilization for Bell’s palsy in the United States. Researchers from Mount Sinai medical school, alongside facial plastic surgeons and a chief resident from Vanderbilt University Medical Center, evaluated data to determine how frequently imaging is used in these cases. Their goal was to assess whether current practices align with established clinical guidelines.
Bell’s palsy is generally diagnosed through comprehensive medical history and physical examination, making imaging unnecessary for uncomplicated cases. The American Academy of Otolaryngology–Head and Neck Surgery recommends steroid treatment within 72 hours of symptom onset, which can significantly improve patient outcomes. The study found that approximately 25% of the 35,942 adult patients included in the analysis received a CT or MRI within 30 days of their diagnosis. This rate contradicts the recommended guidelines.
The research utilized data from the MarketScan Commercial Claims and Encounters Database and the MarketScan Medicare Supplemental Database. Together, these databases represent over 100 million patients, allowing researchers to examine a robust sample of individuals with employer-sponsored private insurance. Only patients with continuous insurance coverage for at least one year post-diagnosis were included.
Patients who underwent imaging were found to be more likely to receive both antiviral and steroid treatments, indicating that providers may be taking extra precautions for patients with more severe symptoms. This trend raises concerns about the overutilization of imaging, which not only inflates healthcare costs but also places unnecessary strain on medical resources.
The study emphasizes the need for healthcare initiatives that align clinical practices with evidence-based guidelines. It highlights the importance of prioritizing thorough history-taking and physical examinations over unnecessary imaging. In most cases, Bell’s palsy resolves within three months without intervention, particularly when treated promptly with corticosteroids.
As patients often experience fear due to the sudden facial paralysis associated with Bell’s palsy—symptoms that can resemble those of a stroke—it is crucial that clinicians respond appropriately. Imaging should only be conducted in cases where patients exhibit concerning symptoms that warrant further investigation.
The research focused on individuals with private insurance and Medicare, and the authors noted that future studies will need to explore imaging practices in populations without private insurance. They also plan to investigate how factors such as race and socioeconomic status may impact imaging trends for Bell’s palsy.
Sujay Ratna, one of the study’s authors, stated, “This study sheds light on the possible overutilization of diagnostic imaging for Bell’s palsy that is idiopathic—without a known cause—compared to the clinical guidelines. Our findings underscore the importance of updating clinical guidelines and disseminating them across all specialties that care for these patients, not just otolaryngology.”
The implications of this study are significant for both healthcare providers and patients. By adhering closely to established guidelines, medical professionals can enhance patient care while effectively managing healthcare resources.
Further details can be found in the paper titled, “Nationwide Analysis of Head and Neck Imaging for Bell’s Palsy: Insights From Healthcare Claims,” authored by Sujay Ratna et al, published in The Laryngoscope in 2025.