Yabing Dong1, Yong Zhu1, Chuan Ma1, Huaqiang Zhao2. 1. College of Stomatology, Shandong University Number 44, Wen Hua Xi Lu, Jinan 250012, Shandong Province, China ; Shandong Provincial Key Laboratory of Oral Biomedicine Number 44, Wen Hua Xi Lu, Jinan 250012, Shandong Province, China. 2. College of Stomatology, Shandong University Number 44, Wen Hua Xi Lu, Jinan 250012, Shandong Province, China.
Abstract
BACKGROUND: To illustrate whether the steroid-antivirals treatment could acquire a better recovery in patients with Bell's palsy than the steroids alone treatment. MATERIALS AND METHODS: We conducted an exhaustive search over Pub med/Medline, Ovid, Elsevier search engines and the Cochrane library thereby collecting the randomized controlled trials in the treatment of patients with Bell's palsy with steroid-antivirals and steroids. The qualities of relevant articles were assessed by GRADE, which was used to present the overall quality of evidence as recommended by the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Two investigators evaluated these papers independently, and resolved the disagreements by discussion. At last 8 eligible papers (1816 patients included: 896 treated with steroid-antivirals and 920 treated with steroids alone) match the criteria. Owing to the result (chi(2) = 12.57, P = 0.08, I(2) = 44%) presented by the formal test for heterogeneity, the fixed effect meta-analysis model was chosen. The facial muscle recovery between the steroids-antivirals group and the steroids alone group show significant differences (OR = 1.52, 95% CI: 1.20-1.94), while the statistical outcome of adverse effect shows no statistical significance (OR = 1.28, 95% CI: 0.71-2.31). CONCLUSIONS: The present meta-analysis indicates that the steroid-antivirals treatment could improve the recovery rate in patients with Bell's palsy when comparing with the steroid alone treatment. CLINICAL SIGNIFICANCE: This meta-analysis showed that the steroid-antivirals treatment achieved the better outcomes in patients with Bell's palsy. Clinicians should consider that steroid-antivirals therapy is an alternative choice for the patients with Bell's palsy.
BACKGROUND: To illustrate whether the steroid-antivirals treatment could acquire a better recovery in patients with Bell's palsy than the steroids alone treatment. MATERIALS AND METHODS: We conducted an exhaustive search over Pub med/Medline, Ovid, Elsevier search engines and the Cochrane library thereby collecting the randomized controlled trials in the treatment of patients with Bell's palsy with steroid-antivirals and steroids. The qualities of relevant articles were assessed by GRADE, which was used to present the overall quality of evidence as recommended by the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Two investigators evaluated these papers independently, and resolved the disagreements by discussion. At last 8 eligible papers (1816 patients included: 896 treated with steroid-antivirals and 920 treated with steroids alone) match the criteria. Owing to the result (chi(2) = 12.57, P = 0.08, I(2) = 44%) presented by the formal test for heterogeneity, the fixed effect meta-analysis model was chosen. The facial muscle recovery between the steroids-antivirals group and the steroids alone group show significant differences (OR = 1.52, 95% CI: 1.20-1.94), while the statistical outcome of adverse effect shows no statistical significance (OR = 1.28, 95% CI: 0.71-2.31). CONCLUSIONS: The present meta-analysis indicates that the steroid-antivirals treatment could improve the recovery rate in patients with Bell's palsy when comparing with the steroid alone treatment. CLINICAL SIGNIFICANCE: This meta-analysis showed that the steroid-antivirals treatment achieved the better outcomes in patients with Bell's palsy. Clinicians should consider that steroid-antivirals therapy is an alternative choice for the patients with Bell's palsy.
Authors: Alessandro Liberati; Douglas G Altman; Jennifer Tetzlaff; Cynthia Mulrow; Peter C Gøtzsche; John P A Ioannidis; Mike Clarke; P J Devereaux; Jos Kleijnen; David Moher Journal: PLoS Med Date: 2009-07-21 Impact factor: 11.069
Authors: Mats Engström; Thomas Berg; Anna Stjernquist-Desatnik; Sara Axelsson; Anne Pitkäranta; Malou Hultcrantz; Mervi Kanerva; Per Hanner; Lars Jonsson Journal: Lancet Neurol Date: 2008-10-10 Impact factor: 44.182
Authors: Frank M Sullivan; Iain R C Swan; Peter T Donnan; Jillian M Morrison; Blair H Smith; Brian McKinstry; Richard J Davenport; Luke D Vale; Janet E Clarkson; Victoria Hammersley; Sima Hayavi; Anne McAteer; Ken Stewart; Fergus Daly Journal: N Engl J Med Date: 2007-10-18 Impact factor: 91.245