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Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long‐term outcomes
Author(s) -
Phillips Katie M.,
Heiser Alyssa,
Gaudin Robert,
Hadlock Tessa A.,
Jowett Nate
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26569
Subject(s) - medicine , synkinesis , pregnancy , bell's palsy , incidence (geometry) , retrospective cohort study , palsy , surgery , pediatrics , physics , alternative medicine , pathology , biology , optics , genetics
Introduction The incidence of Bell's palsy (BP) is elevated in the late phases of pregnancy. Controversy exists as to whether pregnancy is a risk factor for worse outcomes in BP, and whether such outcomes are the result of factors intrinsic to pregnancy or the tendency to withhold medical therapy in this cohort. Methods Long‐term facial function outcomes in cases of pregnancy‐associated BP (PABP) were compared against outcomes in cases affecting nonpregnant adult women of child‐bearing age by a blinded expert using the electronic clinician‐graded facial function scale (eFACE) facial grading system. Results Fifty‐one pregnancy‐associated cases and 58 nonpregnancy‐associated cases were included. Among patients who received early corticosteroid therapy, significantly worse static, synkinesis, and composite facial function eFACE scores were demonstrated among cases of PABP compared to nonpregnancy‐associated cases (static median = 86 vs. 92.5, P = 0.005; synkinesis median = 79 vs. 86, P = 0.007; composite median = 78 vs. 84, P = 0.023). Among those not treated with corticosteroids, significantly worse dynamic and composite facial function eFACE scores were demonstrated in cases of PABP compared to those for nonpregnancy‐associated cases (dynamic median = 74 vs. 92.5, P = 0.038; composite median = 73 vs. 86.5, P = 0.038). A trend toward improved outcomes was demonstrated within both groups for those treated with corticosteroids compared to those who were not. Conclusion In comparison to cases unrelated to pregnancy, late‐term PABP is associated with worse long‐term outcomes to a degree that cannot solely be explained by differences in medical therapy. Level of Evidence 4. Laryngoscope , 127:2854–2859, 2017