Yoo, Hye Won
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Yoon, Lira
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Kim, Hye Young
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Kwak, Min Jung
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Park, Kyung Hee
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Bae, Mi Hye
(Department of Pediatrics, Pusan National University Hospital, Pusan National University School of Medicine and Biochemical Research Institute)
,
Lee, Yunjin
(Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Biochemical Resea)
,
Nam, Sang Ook
,
Kim, Young Mi
Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the effica...
Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.
Purpose: Bell's palsy is characterized by sudden onset of unilateral facial weakness. The use of corticosteroids for childhood Bell's palsy is controversial. This study aimed to identify clinical characteristics, etiology, and laboratory findings in childhood Bell's palsy, and to evaluate the efficacy of corticosteroid treatment. Methods: We conducted a retrospective analysis of children under 19 years of age treated for Bell's palsy between January 2009 and June 2017, and followed up for over 1 month. Clinical characteristics, neuroimaging data, laboratory findings, treatments, and outcomes were reviewed. Patients with Bell's palsy were divided into groups with (group 1) and without (group 2) corticosteroid treatment. Differences in onset age, sex, laterality, infection and vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. Results: One hundred patients were included. Mean age at presentation was $7.4{\pm}5.62years$. A total of 73 patients (73%) received corticosteroids with or without intravenous antiviral agents, and 27 (27%) received only supportive treatment. There was no significant difference in the severity, laboratory findings, or neuroimaging findings between the groups. Significant improvement was observed in 68 (93.2%) and 26 patients (96.3%) in groups 1 and 2, respectively; this rate was not significantly different between the groups (P=0.48). Conclusion: Childhood Bell's palsy showed good prognosis with or without corticosteroid treatment; there was no difference in prognosis between treated and untreated groups. Steroid therapy in childhood Bell's palsy may not significantly improve outcomes.
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제안 방법
Clinical records of children under 19 years of age diagnosed with Bell’s palsy at Pusan National University Hospital between January 2009 and June 2017 were retrospectively reviewed. The criteria for inclusion were a diagnosis of acute peripheral facial nerve palsy, and a follow-up period lasting for at least 1 month. Patients meeting the following criteria were included this study: (1) diagnosed with idiopathic peripheral facial palsy, (2) followed up for at least 1 month, (3) no evidence of systemic diseases, (4) no previous history of facial palsy, and (5) no previous treatment with corticosteroid for facial palsy.
All patients were also examined by an otolaryngologist and an ophthalmologist during the initial work up. The differences in age, sex, laterality, infection or vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. The House-Brackmann score was used to classify the severity of facial palsy (Table 1).
The purpose of this study was to investigate the clinical characteristics and etiology of Bell’s palsy, and to examine the efficacy of corticosteroid treatment by comparing the treated and nontreated groups retrospectively.
대상 데이터
Of the remaining 116 patients, 16 patients were excluded due to follow-up loss. Finally, 100 patients were included in our study (Fig. 1). There was no sexual predilection.
Twenty-eight patients (28%) presented with palsy in spring, 21 in summer, 26 in late fall, and 25 in winter. A seasonal variation in the frequency was not observed in our study (Fig.
데이터처리
*Fisher exact test or Mann-Whitney test was performed.
Statistical analysis was conducted using IBM SPSS Statistics ver. 23.0 (IBM Co., Armonk, NY, USA) and was used to analyze the differences between the groups. Data are presented as means and standard deviations.
이론/모형
Data are presented as means and standard deviations. The Fisher exact test was applied for analyzing categorical data, and the Mann-Whitney test was used for continuous variables. For all analyses, P values <0.
The differences in age, sex, laterality, infection or vaccination history, degree of facial nerve palsy, and prognosis after treatment between the groups were analyzed. The House-Brackmann score was used to classify the severity of facial palsy (Table 1). Severity improvement was defined as a decrease in the grade by 2 or more points, or the achievement of grade I.
성능/효과
This present study was subject to the limitation of all retrospective reviews. Because the data were retrospective in nature, the assessment of the House-Brackmann grades was not protocolized, and it was difficult to timely and definitely determines the time to recovery. We believe that future studies should focus on standardizing a treatment plan, including work-up, clinical evaluation scales, treatment options, and follow-up schedules for children with Bell’s palsy, in order to achieve a better outcome.
In our study, the mean age of Bell’s palsy onset was 7 years 4 months, 50% of patients were female, and 49% of patients showed right-sided Bell’s palsy.
Thirty-nine patients (39%) had a previous history of infections, such as upper respiratory tract infection, herpangina, and hand-footand-mouth disease, within 4 weeks before palsy onset. A respiratory virus polymerase chain reaction (PCR) test were performed in 22 patients (22%) and confirmed that 6 patients were infected with rhinovirus, 1 patient with adenovirus, and 1 patient with corona virus.
참고문헌 (18)
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