Division of Ophthalmology, Lahey Hospital & Medical Center, Peabody, Massachusetts, U.S.A.
Tufts University School of Medicine, Boston, Massachusetts, U.S.A.
Ophthalmic Plast Reconstr Surg. 2022;38(4):381-386. doi: 10.1097/IOP.0000000000002134. Epub 2022 Jan 27.
To analyze long-term outcomes in a large cohort of patients with acute peripheral facial palsy (APFP).
Hospital-based, cross-sectional study. Data were abstracted from the electronic medical record. Time to recovery was assessed with Kaplan-Meier survival analyses. Binary logistic regression analysis was used to identify factors associated with outcome.
Three hundred seventy-two patients with APFP seen at a tertiary hospital between February 2015 and March 2021 were analyzed. Seasonal variation of APFP peaked in the early fall (September 29) and had a peak-to-low ratio of 1.36 (R 2 = 0.329, p < 0.001). Patients who tested positive for Lyme disease (10%) had an earlier peak (July 16) compared with those who were negative (October 15). Eighty-seven percent of patients had complete recovery (averaging 64 ± 61 days). Patients, with higher House-Brackmann (H-B) grades at presentation took longer to recover, were more likely to have aberrant regeneration and had lower final rates of recovery compared with those with lower H-B grades (χ 2 = 12.03, p < 0.001). Of the patients with residual palsies, 70% had evidence of aberrant regeneration, and nearly half of those had hemifacial spasm.
Most patients with APFP achieve complete recovery within 1 year, including those positive for Lyme. More severe palsy at presentation portends a worse outcome.
分析急性周围性面瘫（APFP）大样本患者的长期预后。
基于医院的横断面研究。从电子病历中提取数据。采用 Kaplan-Meier 生存分析评估恢复时间。采用二元逻辑回归分析确定与结局相关的因素。
分析了 2015 年 2 月至 2021 年 3 月在一家三级医院就诊的 372 例 APFP 患者。APFP 的季节性变化在初秋达到高峰（9 月 29 日），高峰与低谷之比为 1.36（R 2 = 0.329，p < 0.001）。莱姆病检测阳性的患者（10%）比莱姆病检测阴性的患者（10 月 15 日）更早达到高峰（7 月 16 日）。87%的患者完全恢复（平均 64±61 天）。发病时 House-Brackmann （H-B）分级较高的患者恢复时间较长，更可能发生异常再生，最终恢复率较低，与 H-B 分级较低的患者相比（χ 2 = 12.03，p < 0.001）。有残留面瘫的患者中，70%有异常再生的证据，近一半有面肌痉挛。
大多数 APFP 患者在 1 年内可完全恢复，包括莱姆病检测阳性的患者。发病时面瘫越严重，预后越差。
