The prognostic value of electroneurography of Bell's palsy at the orbicularis oculi versus nasolabial fold.

OBJECTIVES/HYPOTHESIS: We compared the prognostic value of different placements measured by electroneurography (ENoG) in Bell's palsy, especially among patients with poor results on ENoG.

STUDY DESIGN

Retrospective study using electrodiagnostic data and medical chart review from August 2006 to June 2013 was performed of patients who were diagnosed with Bell's palsy.

METHODS

We included 81 patients treated from August 2006 to June 2013. Initial and final facial function was established clinically by the House-Brackmann scale. Final state of facial palsy was estimated after 6 months from onset of facial palsy. Patients with less than 10% of ENoG response (more than 90% degeneration) were divided into three groups according to ENoG response by electrode placement as follows: group A, ENoG for orbicularis oculi (oculi) ≥ 10% and ENoG for nasolabial fold (NLF) < 10%; group B, ENoG (oculi) < 10% and ENoG (NLF) ≥ 10%; and group C, ENoG (oculi) < 10% and ENoG (NLF) < 10%.

RESULTS

There were no differences in demographic data among the three groups in terms of age, gender, initial paralysis, and days from the onset to ENoG. The complete/nearly complete recovery rates were the following: group A, 49.9%; group B, 75%; group C, 32%. The overall incomplete recovery rate in groups A and C was significantly worse than group B, and group C was the worst (P < 0.05).

CONCLUSION

The results suggest that ENoG of the NLF has more prognostic value in the outcomes of Bell's palsy than ENoG of the oculi, with poorest results in patients with the NLF < 10%.

LEVEL OF EVIDENCE

4. Laryngoscope, 126:1644-1648, 2016.