Determining the Prognosis of Bell's Palsy Based on Severity at Presentation and Electroneuronography.

Autor: Escalante DA; Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA., Malka RE; Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA., Wilson AG; Uniformed Services University, Bethesda, Maryland, USA., Nygren ZS; Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA., Radcliffe KA; Department of Neurology, Madigan Army Medical Center, Tacoma, Washington, USA., Ruhl DS; Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA., Vincent AG; Facial Plastic Surgery Associates, Fort Worth, Texas, USA., Hohman MH; Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2022 Jan; Vol. 166 (1), pp. 151-157. Date of Electronic Publication: 2021 Mar 30.
DOI: 10.1177/01945998211004169
Abstrakt: Objective: To examine the demographics of Bell's palsy and determine how House-Brackmann (HB) grade at nadir and electroneuronography (ENoG) results correlate with HB grade after recovery and development of synkinesis.
Study Design: Retrospective cohort study.
Setting: Tertiary care military medical center.
Methods: Patients with acute Bell's palsy and adequate follow-up, defined as 6 months or return to HB grade I function, were included. Demographic information, HB scores at nadir and recovery, and ENoG results were collected.
Results: A total of 112 patient records were analyzed. Ages ranged from 8 to 87 years with peaks at 21 to 25 and 61 to 65 years. Among patients, 16.3% reached a nadir at HB II, 41.9% at HB III, 5.4% at HB IV, 16.3% at HB V, and 20.1% at HB VI. The overall recovery rate was 73.2% to HB I function, 17.0% to HB II, and 9.8% to HB III. The chance of recovery to HB I decreased as the severity of paralysis increased ( r s = -1.0, P < .0001). Mean time to recovery to HB I was 6 weeks. Greater degeneration on ENoG suggested worse recovery ( r s = 0.62, P = .01). Patients with HB V and VI were most likely to develop synkinesis.
Conclusion: More severe paralysis increased the chance of recovery to HB II or III function. The granularity of this study provides prognostic insights that may inform the counseling of patients with Bell's palsy with respect to prognosis and recovery timeline.
Databáze: MEDLINE
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