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The Efficacy of Corticosteroids in Postparotidectomy Facial Nerve Paresis
Author(s) -
Lee Kimberly J.,
Fee Willard E.,
Terris David J.
Publication year - 2002
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 - 10.1097/00005537-200211000-00009
Subject(s) - medicine , dexamethasone , placebo , surgery , anesthesia , paresis , corticosteroid , facial nerve , alternative medicine , pathology
Objective To determine whether the administration of perioperative corticosteroids is effective in ameliorating facial nerve paresis after parotidectomy. Study Design Prospective, randomized, double‐blinded, placebo‐controlled clinical trial at a university medical center. Methods Patients scheduled for parotidectomy and who met inclusion criteria were invited to enroll in the protocol. They were stratified according to the anticipated surgery (superficial or total parotidectomy) and then received one of two doses of dexamethasone (0.51 or 1.41 mg/kg divided into three doses) or placebo solution immediately preoperatively and then every 8 hours for 16 hours postoperatively. The facial nerve was graded for proportion (percentage) of function at each of the four major regions (frontal, orbital, midface and upper lip, and lower lip). The early postoperative function and rate of return of function were compared among the treatment groups. Results Forty‐nine patients were enrolled and evaluated (18 in the control group, 16 receiving low‐dose dexamethasone, and 15 receiving high‐dose dexamethasone). No therapeutic advantage of dexamethasone treatment could be appreciated with respect to the degree of early postoperative nerve function (81.3% for control patients vs. 69.5% for dexamethasone‐treated patients [ P = .239]). Similarly, the median time to recovery of complete facial nerve function was 60 days in the control group and was 150 days in the dexamethasone‐treated patients. Conclusions Dexamethasone administration in patients undergoing parotidectomy is not justified. Despite the relatively modest risk profile of dexamethasone, we were unable to demonstrate any benefit in patients who were treated with either low‐dose or high‐dose steroids compared with placebo‐treated patients in a randomized, controlled trial.