Takashi Fujiwara1, Yasuharu Haku2, Takuya Miyazaki2, Atsuhiro Yoshida2, Shin-Ich Sato2, Hisanobu Tamaki2. 1. Department of Otolaryngology Head and Neck Surgery, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama 710-8602, Japan. Electronic address: t.fujiwarabi@gmail.com. 2. Department of Otolaryngology Head and Neck Surgery, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki, Okayama 710-8602, Japan.
Abstract
OBJECTIVE: The aim of this study was to evaluate the effectiveness of high-dose corticosteroid (120mg prednisolone equivalent daily) in Bell's palsy compared with low-dose corticosteroid (60mg PSL equivalent). METHODS: A single-center retrospective observational study was performed. We included adult Bell's palsy patients who were treated within 7days after disease onset. We compared high- and low-dose corticosteroid for the non-recovery rate at 6 months after disease onset using inverse probability-weighted propensity score analysis (IPW-PS). RESULTS: A total of 368 Bell's palsy patients (281 in the high-dose and 87 in the low-dose group) were included. The non-recovery rate without IPW-PS was 13.8% in the low-dose and 8.2% in the high-dose group. After IPW-PS adjustment, the non-recovery rate was 13.1% in the low-dose and 7.8% in the high-dose group (difference=-5.28%, 95% confidence interval [CI] -12.7% to -2.1%, p=0.040). High-dose corticosteroid decreased the non-recovery rate in severe Bell's palsy patients with a Yanagihara score of 0-10 (difference=-16.1%, 95% CI -38.5% to -6.2%, p=0.012), but did not decrease in moderate Bell's palsy patients with a Yanagihara score of 12-18 (difference=-2.0%, 95% CI -11.0% to 7.0%, p=0.591). Subgroup analysis revealed that the efficacy of high-dose corticosteroids was higher when patients were treated within 3days after disease onset, but not when patients were treated at 4days or later after disease onset. CONCLUSIONS: Physicians would be better to treat severe Bell's palsy patients with high-dose corticosteroids when the patients are treated within 3days after disease onset.
OBJECTIVE: The aim of this study was to evaluate the effectiveness of high-dose corticosteroid (120mg prednisolone equivalent daily) in Bell's palsy compared with low-dose corticosteroid (60mg PSL equivalent). METHODS: A single-center retrospective observational study was performed. We included adult Bell's palsypatients who were treated within 7days after disease onset. We compared high- and low-dose corticosteroid for the non-recovery rate at 6 months after disease onset using inverse probability-weighted propensity score analysis (IPW-PS). RESULTS: A total of 368 Bell's palsypatients (281 in the high-dose and 87 in the low-dose group) were included. The non-recovery rate without IPW-PS was 13.8% in the low-dose and 8.2% in the high-dose group. After IPW-PS adjustment, the non-recovery rate was 13.1% in the low-dose and 7.8% in the high-dose group (difference=-5.28%, 95% confidence interval [CI] -12.7% to -2.1%, p=0.040). High-dose corticosteroid decreased the non-recovery rate in severe Bell's palsypatients with a Yanagihara score of 0-10 (difference=-16.1%, 95% CI -38.5% to -6.2%, p=0.012), but did not decrease in moderate Bell's palsypatients with a Yanagihara score of 12-18 (difference=-2.0%, 95% CI -11.0% to 7.0%, p=0.591). Subgroup analysis revealed that the efficacy of high-dose corticosteroids was higher when patients were treated within 3days after disease onset, but not when patients were treated at 4days or later after disease onset. CONCLUSIONS: Physicians would be better to treat severe Bell's palsypatients with high-dose corticosteroids when the patients are treated within 3days after disease onset.