Premium
Idiopathic facial nerve paralysis: A randomized double blind controlled study of placebo versus prednisone
Author(s) -
Austin John R.,
Peskind Steven P.,
Rice Dale H.,
Austin Sara G.
Publication year - 1993
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 - 10.1288/00005537-199312000-00002
Subject(s) - prednisone , placebo , medicine , denervation , electroneuronography , facial nerve , anesthesia , facial paralysis , randomized controlled trial , surgery , etiology , paralysis , pathology , alternative medicine
Idiopathic facial nerve paralysis (IFNP) is a common malady. Because its etiology is unclear, there are a variety of treatment options. Studies to date have not clearly established the benefits of treatment with oral steroids (prednisone). The authors performed a randomized double‐blind controlled study comparing the use of placebo versus prednisone which shows that prednisone‐treated patients benefit from early treatment. Seventy‐six patients met inclusion criteria and completed follow‐up until recovery; 35 patients received prednisone and 41 received placebo. Their mean age was 36.8 years. Facial nerve function was assessed using the House‐Brackmann facial nerve grading scale, as well as a variety of other measures. Patients were evaluated pretreatment, regularly post‐treatment until judged recovered (return of facial function to a grade III or better), and at 6 months after recovery. Difference in mean time to resolution for the prednisone (51.4 days) and placebo (69.3 days) groups was not statistically significant. There was a significant difference in grade at recovery, with the placebo group having a higher proportion of grade III results ( P <.03). Eight of 10 patients with electroneurography (ENOG) evidence of denervation were in the placebo group and accounted for 6 of the 7 grade III results. However, the difference in proportion of patients with evidence of denervation for the prednisone (5.7%) and placebo (19.5%) groups did not achieve statistical significance. This study shows that patients treated with prednisone have less denervation than placebo‐treated patients. They also have a significant improvement in facial grade at recovery compared to placebo‐treated patients. Therefore, the authors recommend that all patients at risk for developing denervation receive prednisone treatment.