Intratympanic steroid therapy for Bell’s palsy with poor prognostic results

Abstract In Bell’s palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient’s prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST)...

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Autores principales:	Akira Inagaki, Sachiyo Katsumi, Shinji Sekiya, Shingo Murakami
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f14711da77c247b1b5fce1bdf8d0f0f0
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spelling	oai:doaj.org-article:f14711da77c247b1b5fce1bdf8d0f0f02021-12-02T14:30:52ZIntratympanic steroid therapy for Bell’s palsy with poor prognostic results10.1038/s41598-021-87551-x2045-2322https://doaj.org/article/f14711da77c247b1b5fce1bdf8d0f0f02021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87551-xhttps://doaj.org/toc/2045-2322Abstract In Bell’s palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient’s prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST) is an effective treatment for Bell’s palsy patients with poor electrodiagnostic test results (≤ 10% electroneurography value). Patients in the concurrent ITST group (n = 8) received the standard systemic dose of prednisolone (410 mg total) and intratympanic dexamethasone (16.5 mg total) and those in the control group (n = 21) received systemic prednisolone at the standard dose or higher (average dose, 605 ± 27 mg). A year after onset, the recovery rate was higher in the ITST group than in the control group (88% vs 43%, P = 0.044). The average House-Brackmann grade was better in the concurrent ITST group (1.13 ± 0.13 vs 1.71 ± 0.16, P = 0.035). Concurrent ITST improves the facial nerve outcome in patients with poor electroneurography test results, regardless of whether equivalent or lower glucocorticoid doses were administered. This may be ascribed to a neuroprotective effect of ITST due to a higher dose of steroid reaching the lesion due to dexamethasone transfer in the facial nerve.Akira InagakiSachiyo KatsumiShinji SekiyaShingo MurakamiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Akira Inagaki Sachiyo Katsumi Shinji Sekiya Shingo Murakami Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
description	Abstract In Bell’s palsy, electrodiagnosis by electroneurography (ENoG) is widely used to predict a patient’s prognosis. The therapeutic options for patients with poor prognostic results remain controversial. Here, we investigated whether early intervention with intratympanic steroid therapy (ITST) is an effective treatment for Bell’s palsy patients with poor electrodiagnostic test results (≤ 10% electroneurography value). Patients in the concurrent ITST group (n = 8) received the standard systemic dose of prednisolone (410 mg total) and intratympanic dexamethasone (16.5 mg total) and those in the control group (n = 21) received systemic prednisolone at the standard dose or higher (average dose, 605 ± 27 mg). A year after onset, the recovery rate was higher in the ITST group than in the control group (88% vs 43%, P = 0.044). The average House-Brackmann grade was better in the concurrent ITST group (1.13 ± 0.13 vs 1.71 ± 0.16, P = 0.035). Concurrent ITST improves the facial nerve outcome in patients with poor electroneurography test results, regardless of whether equivalent or lower glucocorticoid doses were administered. This may be ascribed to a neuroprotective effect of ITST due to a higher dose of steroid reaching the lesion due to dexamethasone transfer in the facial nerve.
format	article
author	Akira Inagaki Sachiyo Katsumi Shinji Sekiya Shingo Murakami
author_facet	Akira Inagaki Sachiyo Katsumi Shinji Sekiya Shingo Murakami
author_sort	Akira Inagaki
title	Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
title_short	Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
title_full	Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
title_fullStr	Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
title_full_unstemmed	Intratympanic steroid therapy for Bell’s palsy with poor prognostic results
title_sort	intratympanic steroid therapy for bell’s palsy with poor prognostic results
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f14711da77c247b1b5fce1bdf8d0f0f0
work_keys_str_mv	AT akirainagaki intratympanicsteroidtherapyforbellspalsywithpoorprognosticresults AT sachiyokatsumi intratympanicsteroidtherapyforbellspalsywithpoorprognosticresults AT shinjisekiya intratympanicsteroidtherapyforbellspalsywithpoorprognosticresults AT shingomurakami intratympanicsteroidtherapyforbellspalsywithpoorprognosticresults
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Intratympanic steroid therapy for Bell’s palsy with poor prognostic results

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