Vol.96 No.10 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No.10 October 2003
Clinical Study of Therapeutic Effect of High-Dose Steroid
Therapy (HDST) for Peripheral Facial Palsy
Satsuki Yasumura, Shin Aso, Masahito Tsubota,
Masatsugu Asai and Yukio Watanabe
(Toyama Medical and Pharmaceutical University)
Excellent response to HDST has been reported in patients with idiopathic facial nerve palsy. However, surgical decompression of facial nerves in severe cases remains controversial. In this study, outcomes obtained through HDST and those obtained through conventional therapy were compared, and the outcomes of decompression surgery after medical treatments were analyzed.
Subjects were 119 outpatients with severe facial palsy treated at our clinic, who satisfied the following criteria: 1) the first treatment was performed within 3 weeks after onset; 2) grade of palsy was scored as less than 10 of 40. Sixty-one (Group A) patients were treated with our conventional therapy using dexamethazone between 1984 and 1989, and 58 (Group B) with HDST between 1990 and 2001. Eighteen patients (29.5％) in Group A and 7 (12.1％) in Group B underwent surgery due to the absence of satisfactory response to medical treatments and poor electrical-test results.
Seventeen (73.9％) of 23 patients with Bell's palsy in Group A and 18 (94.7％) of 19 in Group B, and 1 of 2 patients with Ramsay Hunt syndrome in Group A and 9 of 12 in Group B, showed complete recovery with medical treatment only and did not receive surgical treatment. Among patients receiving surgical decompression, only 1 in Group A and none in Group B showed complete recovery.
As a results of medical treatment, palsy improved and the number of patients undergoing surgical treatment decreased after introduction of HDST. Surgical outcomes of surgery in severe cases were not satisfactory, suggesting the limitations of surgery.
Key words : steroid therapy, facial palsy, surgical decompression, outcome