School of Medicine, University of California San Diego, La Jolla, California, USA.
Department of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, California, USA.
Laryngoscope. 2024 Feb;134(2):911-918. doi: 10.1002/lary.30895. Epub 2023 Jul 20.
We characterize occult lesion diagnosis rates after initial Bell's palsy diagnoses.
A de-identified database of all facial palsy patients who presented to an extensive health care system across 22 years was created using Epic SlicerDicer. Among patients with Bell's palsy diagnoses, we extracted demographic and any subsequent occult lesion diagnosis data across various clinical sites. Descriptive and multivariable regression analyses comparing patients with occult lesion diagnoses made at different time points were included.
Among the total 3912 facial palsy patients, 2240 had Bell's palsy diagnoses, of which 217 (9.7%) had subsequent lesion diagnoses at a median (IQR) of 12.3 (4.2, 23.8) months, consisting of cranial nerve neoplasms (62.2%), parotid gland neoplasms (34.1%), and cholesteatomas (3.7%). Although a large proportion of total lesions were diagnosed within the first 3 months (19.8%), 69.5% were diagnosed after 6 months. There were no demographic differences among patients diagnosed with different lesion types, but Asian patients were more likely to be diagnosed with occult lesions after 12 months after Bell's palsy diagnosis compared with white patients (odds ratio = 6.2, p = 0.001).
In one of the largest Bell's palsy cohorts to date, we identified a 9.7% occult lesion diagnosis rate at a median of 12.3 months after Bell's palsy diagnosis. These data underscore the importance of timely workup for occult lesions in cases of facial palsy with no signs of recovery after 3-4 months.
4 Laryngoscope, 134:911-918, 2024.
我们描述初次贝尔麻痹诊断后隐匿性病变的诊断率。
使用 Epic SlicerDicer 创建了一个包含 22 年来就诊于广泛医疗系统的所有面瘫患者的去识别数据库。在贝尔麻痹诊断患者中，我们从各个临床部位提取了人口统计学资料和任何后续隐匿性病变的诊断数据。包括比较不同时间点隐匿性病变诊断患者的描述性和多变量回归分析。
在总共 3912 例面瘫患者中，2240 例有贝尔麻痹诊断，其中 217 例（9.7%）在中位数（IQR）12.3（4.2，23.8）个月后有后续病变诊断，包括颅神经肿瘤（62.2%）、腮腺肿瘤（34.1%）和胆脂瘤（3.7%）。尽管大部分总病变在最初 3 个月内被诊断（19.8%），但 69.5%的病变在 6 个月后被诊断。不同病变类型的患者在人口统计学上没有差异，但与白人患者相比，亚洲患者在贝尔麻痹诊断后 12 个月后更有可能被诊断为隐匿性病变（比值比=6.2，p=0.001）。
在迄今为止最大的贝尔麻痹队列之一中，我们发现 9.7%的隐匿性病变在贝尔麻痹诊断后中位数为 12.3 个月时被诊断。这些数据强调了在面瘫患者中，在 3-4 个月后无恢复迹象时，及时进行隐匿性病变检查的重要性。
4 级喉镜，134：911-918，2024。
