PDF(Pubmed)
Abstract：
Background Facial nerve paralysis, leading to the loss of facial expression, poses significant discomfort to patients. While most individuals exhibit a favorable response to treatment, a subset experiences enduring facial deformities without clearly defined etiology. This study aimed to identify prognostic factors influencing outcomes and quality of life in facial nerve palsy patients, contributing to enhanced clinical management. Methods A prospective observational study was conducted in the Otorhinolaryngology Department of Maharaja Krishna Chandra Gajapati Medical College and Hospital, a tertiary care hospital. We included patients presenting with any clinical variety of facial nerve palsy, irrespective of age and gender. Only moribund and noncompliant cases were excluded. Patients underwent clinical assessment using the House-Brackmann (HB) grading at presentation and were subsequently monitored at three weeks, three months, and six months post-onset to assess recovery. Results Out of 66 patients, 18 (27.27%) fully recovered at three weeks, 50 (75.76%) recovered at three months, and 54 (81.82%) at six-month follow-up. Incomplete recovery was observed in 13 (19.69%) patients. Factors associated with favorable outcomes included younger age of onset (p = 0.003), lower baseline HB grade (IV or less) (p = 0.001), Electroneurography Degeneration Index (ENoG DI) of <70% (p < 0.0001), early initiation of treatment (within five days of onset) (p = 0.0003), and absence of comorbid conditions (p = 0.03). Gender and affected side (left or right) did not influence the outcome. Conclusion In summary, age, associated comorbid conditions, baseline HB grade, and extent of facial nerve degeneration are crucial predictors of outcomes in facial nerve palsy. This knowledge can guide clinicians in optimizing treatment strategies for improved patient care.
摘要：
背景面神经麻痹,导致面部表情的丧失，给患者带来明显的不适。虽然大多数人对治疗表现出良好的反应，一个子集经历持久的面部畸形，没有明确的病因。本研究旨在确定影响面神经麻痹患者预后和生活质量的预后因素。有助于加强临床管理。方法在MaharajaKrishnaChandraGajapati医学院和医院的耳鼻咽喉科进行了一项前瞻性观察研究，三级护理医院。我们纳入了任何临床面神经麻痹的患者，不论年龄和性别。仅排除垂死和不合规的病例。患者在就诊时使用House-Brackmann（HB）分级进行临床评估，随后在三周进行监测。三个月,和发病后六个月评估恢复情况。结果66例患者中,18（27.27%）在三周内完全恢复，50（75.76％）在三个月时恢复，和54（81.82%）在六个月的随访。13例（19.69％）患者未完全恢复。与有利结局相关的因素包括发病年龄较小（p=0.003），较低的基线HB等级（IV或更低）（p=0.001），神经电图退化指数(EnoGDI)<70%(p<0.0001)，早期开始治疗（发病五天内）（p=0.0003），并且没有合并症条件(p=0.03)。性别和患侧（左或右）不影响结果。结论总之,年龄,相关的合并症，基线HB等级,面神经退化的程度是面神经麻痹预后的关键预测因素。这些知识可以指导临床医生优化治疗策略以改善患者护理。
