Prognostication of recovery time after acute peripheral facial palsy: a prospective cohort study.

Authors:
Gerd Fabian Volk
Gerd Fabian Volk
Jena University Hospital
Germany
Carsten Klingner
Carsten Klingner
Jena University Hospital
Germany
Mira Finkensieper
Mira Finkensieper
Jena University Hospital
Germany
Otto W Witte
Otto W Witte
Jena University Hospital
Germany
Orlando Guntinas-Lichius
Orlando Guntinas-Lichius
Jena University Hospital
Germany

BMJ Open 2013 Jun 20;3(6). Epub 2013 Jun 20.

Departments of Otorhinolaryngology, Jena University Hospital, Jena, Germany.

Objective: Owing to a lack of prospective studies, our aim was to evaluate diagnostic factors, in particular, motor and non-motor function tests, for prognostication of recovery time in patients with acute facial palsy (AFP).

Design: Prospective cohort study.

Setting: University hospital.

Participants: 259 patients with AFP.

Measurements: Clinical data, facial grading, electrophysiological motor function tests and other non-motor function tests were assessed for their contribution to recovery time.

Results: The predominant origin of AFP was idiopathic (59%) and traumatic (21%). At baseline, the House-Brackmann scale (HB) was >III in 46% of patients. Follow-up time was 5.6±9.8 months with a complete recovery rate of 49%. The median recovery time was 3.5 months (95% CI 2.2 to 4.7 months). The following variables were associated with faster recovery: Interval between onset of AFP and treatment <6 days versus ≥6 days (median recovery time in months 2.1 vs 6.5; p<0.0001); HB ≤III vs >III (2.2 vs 4.6; p=0.001); no versus presence of pathological spontaneous activity in first electromyography (EMG; 2.8 vs probability of recovery <50%; p<0.0001); no versus voluntary activity in EMG (probability of recovery <50% vs 3.1; p<0.0001); normal versus pathological ipsilateral electroneurography (1.9 vs 6.5; p=0.008), normal versus pathological stapedius reflexes (1.6 vs 3.3; p=0.003).

Conclusions: Start of treatment and grading, but most importantly EMG evaluated for pathological spontaneous activity and the stapedius reflex test are powerful prognosticators for estimating the recovery time from AFP. These results need confirmation in larger datasets.

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2013-003007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669721PMC

Still can't find the full text of the article?

Let us try to send a request to the authors directly.
June 2013
8 Reads

Publication Analysis

Top Keywords

function tests
12
recovery time
12
facial palsy
8
prognostication recovery
8
non-motor function
8
prospective cohort
8
recovery
5
recovery timeresults
4
timeresults predominant
4
afp idiopathic
4
traumatic 21%
4
21% baseline
4
59% traumatic
4
idiopathic 59%
4
origin afp
4
predominant origin
4
assessed contribution
4
clinical data
4
data facial
4
afpmeasurements clinical
4

Similar Publications