Escalante Derek A, Malka Ronit E, Wilson Allison G, Nygren Zachary S, Radcliffe Kristofer A, Ruhl Douglas S, Vincent Aurora G, Hohman Marc H
Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.
Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA.
Otolaryngol Head Neck Surg. 2022 Jan;166(1):151-157. doi: 10.1177/01945998211004169. Epub 2021 Mar 30.
To examine the demographics of Bell's palsy and determine how House-Brackmann (HB) grade at nadir and electroneuronography (ENoG) results correlate with HB grade after recovery and development of synkinesis.
Retrospective cohort study.
Tertiary care military medical center.
Patients with acute Bell's palsy and adequate follow-up, defined as 6 months or return to HB grade I function, were included. Demographic information, HB scores at nadir and recovery, and ENoG results were collected.
A total of 112 patient records were analyzed. Ages ranged from 8 to 87 years with peaks at 21 to 25 and 61 to 65 years. Among patients, 16.3% reached a nadir at HB II, 41.9% at HB III, 5.4% at HB IV, 16.3% at HB V, and 20.1% at HB VI. The overall recovery rate was 73.2% to HB I function, 17.0% to HB II, and 9.8% to HB III. The chance of recovery to HB I decreased as the severity of paralysis increased ( = -1.0, < .0001). Mean time to recovery to HB I was 6 weeks. Greater degeneration on ENoG suggested worse recovery ( = 0.62, = .01). Patients with HB V and VI were most likely to develop synkinesis.
More severe paralysis increased the chance of recovery to HB II or III function. The granularity of this study provides prognostic insights that may inform the counseling of patients with Bell's palsy with respect to prognosis and recovery timeline.
研究贝尔面瘫的人口统计学特征，并确定最低点时的House-Brackmann（HB）分级以及神经电图（ENoG）结果与恢复后的HB分级和联带运动发展之间的相关性。
回顾性队列研究。
三级医疗军事医学中心。
纳入急性贝尔面瘫且随访充分的患者，随访充分定义为6个月或恢复至HB I级功能。收集人口统计学信息、最低点及恢复时的HB评分以及ENoG结果。
共分析了112份患者记录。年龄范围为8至87岁，高峰出现在21至25岁和61至65岁。患者中，16.3%在最低点时为HB II级，41.9%为HB III级，5.4%为HB IV级，16.3%为HB V级，20.1%为HB VI级。总体恢复率为恢复至HB I级功能的占73.2%，恢复至HB II级的占17.0%，恢复至HB III级的占9.8%。恢复至HB I级的机会随着瘫痪严重程度的增加而降低（ = -1.0， <.0001）。恢复至HB I级的平均时间为6周。ENoG上更大程度的变性提示恢复较差（ = 0.62， = .01）。HB V级和VI级的患者最有可能出现联带运动。
更严重的瘫痪增加了恢复至HB II级或III级功能的机会。本研究的详细数据提供了预后见解，可为贝尔面瘫患者的预后和恢复时间线咨询提供参考。
