Clinical Prediction of the Prognostic Factors for Recovery of Bell's Palsy

Objectives: The aim of the study was to determine the prognosis of children with Bell’s palsy and analyze the prognostic factors affecting early recovery. Methods: The records of children with a diagnosis of Bell’s palsy were retrospectively analyzed. Demographic and clinical features including age, gender, House-Brackmann Facial Nerve Grading System House-Brackmann Grading Scale (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. Laboratory findings such as red blood cell distribution width and neutrophil-to-lymphocyte ratio were noted. The patients who were recovered within the first month (early recovery) were compared with the patients who were recovered after first month (late recovery) in terms of demographic, clinical characteristics, laboratory findings and treatment modalities in order to determine the risk factors affecting early recovery. Results: A total of 102 children (65 girls and 37 boys) with a mean age of 10.37 ± 4.2 years were included in the study. The complete recovery was detected in 101 children (%99) with Bell’s palsy. Statistically significant difference was found in terms of dosage and time of onset of steroid treatment ( P = .04, P = .035, respectively) and House-Brackmann Facial Nerve Grading System grade on the 10th day ( P = .001) between the early and late recovery groups. Conclusion: The prognosis of Bell’s palsy in children was very good. The prognostic factors affecting the early recovery were being House-Brackmann Facial Nerve Grading System grade 2 or 3 on the 10th day and receiving steroid treatment in the first 24 hours. Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not found to be predictive factors for early recovery.

Download Full-text

Predictive Values of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Other Prognostic Factors in Pediatric Patients With Bell’s Palsy

Ear Nose & Throat Journal ◽

10.1177/0145561320922097 ◽

2020 ◽

pp. 014556132092209 ◽

Cited By ~ 1

Author(s):

Dong Hyun Kim ◽

Jae Hwan Oh ◽

Junsuk Kim ◽

Chang Hyun Cho ◽

Ju Hyoung Lee

Keyword(s):

Prognostic Factors ◽

Pediatric Patients ◽

Bell’S Palsy ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

Low Grade ◽

High Grade ◽

Bell's Palsy ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio

Background and Objectives: Bell’s palsy (BP) is the most frequent cause of unilateral facial paralysis, and inflammation is believed to play an important role in pathogenesis. Due to its rarity, however, no consensus has been reached regarding optimum treatment or factors affecting prognosis. In the present study, treatment outcomes and prognostic factors of BP were investigated in pediatric patients who underwent steroid therapy. The goal was to investigate the relationship between BP and inflammation using multiple inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell distribution width (RDW). Materials and Methods: In all, 54 patients diagnosed with BP and 39 healthy randomly selected controls were enrolled in this retrospective study. Demographic characteristics and complete blood cell count test results were compared. In addition, prognostic factors were sought by dividing the 54 patients with BP into 2 groups according to the House-Brackmann grading system: low grade BP (grades II and III) and high grade BP (grades IV and V). Serum samples were analyzed retrospectively on initial presentation and 6 months after the symptom begins. Meaningful hematological parameters include NLR, PLR, MPV, and RDW. Results: The NLR values in the BP group were significantly higher than in the control group. The NLR value in the 2 groups of patients with BP differed significantly. The mean PLR value in the BP group was higher than in the control group; however, there were no significant differences between the low-grade and high-grade BP groups nor were there any statically significant differences in the other characteristics. Conclusion: The NLR and PLR values are readily accessible parameters that may be useful prognostic markers in pediatric patients with BP. Further studies are required to confirm these results and their utility in predicting prognosis and treating pediatric patients with BP.

Download Full-text