Dehghani Nima, Azarsina Mohadeseh, Mahmoudi Xaniar, Hassantash Sahar
Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran.
Restorative Dentistry Specialist, Tehran University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2025;14(2):3-10. doi: 10.61186/wjps.14.2.3.
Bell's palsy is an acute, asymmetrical paralysis of facial muscles resulting from peripheral facial nerve dysfunction without a discernible origin. Combination therapy, which leverages the benefits of both antivirals and steroids, may be an effective treatment for Bell's palsy. We aimed to evaluate the effectiveness of steroids antiviral treatments for facial paralysis.
A systematic search was conducted using the Scopus, PubMed, and Web of Science databases. The search terms used were: (Bell's palsy OR facial palsy) AND (steroids OR corticosteroids) AND antiviral. All selected articles were published between 1990 and Jan 2023. Comprehensive Meta-Analysis (CMA) version 3 was used for statistical analysis and graph construction.
After a full-text evaluation, 14 studies were included. The comparison of patient outcomes between the two treatment groups indicated that combination therapy was more effective than single therapy. Famciclovir, valacyclovir, and acyclovir, respectively, showed the most significant synergistic effect with corticosteroids. According to Egger's test, no significant bias was found in the comparison of the two treatment groups.
Combination therapy (corticosteroid and antiviral) is significantly more effective than single corticosteroid therapy. Among the antiviral agents, famciclovir, valacyclovir, and acyclovir demonstrated the highest efficacy in combination with corticosteroids.
贝尔氏面瘫是一种急性、不对称的面部肌肉麻痹，由周围性面神经功能障碍引起，病因不明。联合治疗利用了抗病毒药物和类固醇的优势，可能是治疗贝尔氏面瘫的有效方法。我们旨在评估类固醇抗病毒治疗对面瘫的有效性。
使用Scopus、PubMed和Web of Science数据库进行系统检索。使用的检索词为：（贝尔氏面瘫或面瘫）AND（类固醇或糖皮质激素）AND抗病毒药物。所有入选文章均发表于1990年至2023年1月之间。使用综合Meta分析（CMA）第3版进行统计分析和图表构建。
经过全文评估，纳入了14项研究。两个治疗组患者结局的比较表明，联合治疗比单一治疗更有效。泛昔洛韦、伐昔洛韦和阿昔洛韦分别与糖皮质激素显示出最显著的协同作用。根据Egger检验，两个治疗组的比较中未发现显著偏倚。
联合治疗（糖皮质激素和抗病毒药物）明显比单一糖皮质激素治疗更有效。在抗病毒药物中，泛昔洛韦、伐昔洛韦和阿昔洛韦与糖皮质激素联合使用时疗效最高。
