Corticosteroids for Bell’s Palsy (idiopathic facial paralysis)

What we already know about this topic
- “Clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell’s palsy patients 16 years and older” (American Academy of Otolaryngology—Head and Neck Surgery Foundation Guidelines 2013 [3]);
- “We recommend the use of corticosteroids for all patients with Bell palsy” (Canadian Society of Otolaryngology – Head and Neck Surgery and Canadian Neurological Sciences Federation Guidelines 2014 [4]).
The Cochrane review
Results
Outcome | No. of patients / No. of studies | Risk ratio (95% C.I.) | Quality of evidence |
Incomplete recovery 6 months |
895 / 7 | 0,63 (0,50 - 0,80) | High |
Cosmetically disabling persistent sequelae of facial paralysis six or more after randomization |
75 / 2 | 0,96 (0,40 – 2.29) | Low |
Corticosteroids therapy related adverse effects |
715 / 3 | 1,04 (0,71 – 1.51) | Moderate |
Comment and conclusions
Bibliography:
- Monini S, Lazzarino AI, Iacolucci C, Buffoni A, Barbara M. Epidemiology of Bell’s palsy in an Italian Health District: incidence and case-control study. Acta Laryngol. Acta Otorhinolaryngol Ital 2010; 30: 198-204.
- Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2015 Nov 9;(11):CD001869.
- Baugh BF, Basura GJ, Ishii LE, Schwartz SR, Murray Drumheller C, Burkholder R, Deckard NA, Dawson C, Driscoll C, Gillespie MB, Gurgel RK, Halperin J, Khalid AN, Kumar KA, Micco A, Munsell A, Rosenbaum S, Vaughan W. Clinical Practice Guideline: Bell’s Palsy. Otolaryngol Head Neck Surg 2013; 149(3S) S1–S27.
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- Madhok VB, Gagyor I, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F. Corticosteroids for Bell’s Palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2016;(7): CD001942. DOI: 10.1002/14651858.CD001942.pub5.
- House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg (1985); 93: 146–147. https://www.ncbi.nlm.nih.gov/pubmed/3921901
- Salinas RA, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2010 Mar 17;(3):CD001942.