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Fann LY, Wen YL, Huang YC, Cheng CC, Huang YC, Fang CC, Chen WT, Yu PY, Pan HY, Kao LT. Depressive disorder and elevated risk of bell's palsy: a nationwide propensity score-weighting study. BMC Psychiatry 2024; 24:284. [PMID: 38627723 PMCID: PMC11020612 DOI: 10.1186/s12888-024-05730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Prior studies have reported a potential relationship between depressive disorder (DD), immune function, and inflammatory response. Some studies have also confirmed the correlation between immune and inflammatory responses and Bell's palsy. Considering that the pathophysiology of these two diseases has several similarities, this study investigates if DD raises the risk of developing Bell's palsy. METHODS This nationwide propensity score-weighting cohort study utilized Taiwan National Health Insurance data. 44,198 patients with DD were identified as the DD cohort and 1,433,650 adult subjects without DD were identified as the comparison cohort. The inverse probability of treatment weighting (IPTW) strategy was used to balance the differences of covariates between two groups. The 5-year incidence of Bell's palsy was evaluated using the Cox proportional-hazard model, presenting results in terms of hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS The average age of DD patients was 48.3 ± 17.3 years, and 61.86% were female. After propensity score-weighting strategy, no significant demographic differences emerged between the DD and comparison cohort. The Cox proportional hazards model revealed a statistically significant adjusted IPTW-HR of 1.315 (95% CI: 1.168-1.481) for Bell's palsy in DD patients compared to comparison subjects. Further independent factors for Bell's palsy in this model were age (IPTW-HR: 1.012, 95% CI: 1.010-1.013, p < 0.0001), sex (IPTW-HR: 0.909, 95% CI: 0.869-0.952, p < 0.0001), hypertension (IPTW-HR: 1.268, 95% CI: 1.186-1.355, p < 0.0001), hyperlipidemia (IPTW-HR: 1.084, 95% CI: 1.001-1.173, p = 0.047), and diabetes (IPTW-HR: 1.513, 95% CI: 1.398-1.637, p < 0.0001) CONCLUSION: This Study confirmed that individuals with DD face an elevated risk of developing Bell's palsy. These findings hold significant implications for both clinicians and researchers, shedding light on the potential interplay between mental health and the risk of certain physical health outcomes.
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Affiliation(s)
- Li-Yun Fann
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
- Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yuan-Liang Wen
- School of Pharmacy, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, 114201, Taipei City, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chieh Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Chien Cheng
- University of Taipei, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Department of Obstetrics/Gynecology, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Che Huang
- Department of Anesthesia and Critical Care Medicine, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Chih-Chia Fang
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Wan-Ting Chen
- Department of Nursing, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan
| | - Pei-Yeh Yu
- Department of Anesthesiology, Taipei City Hospital Ren Ai branch, Taipei, Taiwan
| | - Hsiang-Yi Pan
- Department of Pharmacy Practice, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, 114202, Taipei City, Taiwan.
| | - Li-Ting Kao
- School of Pharmacy, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, 114201, Taipei City, Taiwan.
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
- Department of Pharmacy Practice, Tri-Service General Hospital, No.325, Sec.2, Chenggong Rd., Neihu District, 114202, Taipei City, Taiwan.
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Hu C, Wei KC, Wang WH, Chang YC, Huang YT. Association of Influenza Vaccination With Risk of Bell Palsy Among Older Adults in Taiwan. JAMA Otolaryngol Head Neck Surg 2023; 149:726-734. [PMID: 37347468 PMCID: PMC10288376 DOI: 10.1001/jamaoto.2023.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2023]
Abstract
Importance Annual administration of the influenza vaccine (fluVc) is currently the most effective method of preventing the influenza virus in older adults. However, half of adults older than 65 years remain unvaccinated in Taiwan, possibly because of concern about adverse events, such as Bell palsy (BP). Currently, studies on the association between fluVc and risk of BP are inconsistent. Objective To determine whether the incidence of BP increases following fluVc in older adults. Design, Setting, and Participants A self-controlled case series study design was used. Days 1 through 7, days 8 through 14, days 15 through 30, and days 31 through 60 following fluVc were identified as risk intervals, and days 61 through 180 were considered the control interval. A total of 4367 vaccinated individuals aged 65 years or older who developed BP within 6 months following fluVc were enrolled. Population-based retrospective claims data were obtained between 2010 and 2017; data were analyzed from April 2022 through September 2022. Exposure Government-funded seasonal fluVc. Main Outcomes and Measures The outcome of interest was BP onset in risk intervals compared with control intervals. Three or more consecutive diagnoses of BP within 60 days following fluVc were used as the definition of a patient with BP. Poisson regression was used to analyze the incidence rate ratio (IRR) of risk intervals compared with control intervals. Results In total, 13 261 521 patients who received the fluVc were extracted from the National Health Insurance Research Database in Taiwan from January 1, 2010, to December 31, 2017. Of those, 7 581 205 patients older than 65 years old met the inclusion criteria. The number of patients with BP diagnosed within 6 months following fluVc enrolled for risk analysis was 4367 (mean [SD] age, 74.19 [5.97] years; 2349 [53.79%] female patients). The incidence rate of BP among all observed fluVc older adults was 57.87 per 100 000 person-years. The IRRs for BP on days 1 through 7, days 8 through 14, and days 15 through 30 were 4.18 (95% CI, 3.82-4.59), 2.73 (95% CI, 2.45-3.05), and 1.67 (95% CI, 1.52-1.84), respectively. However, there was no increase during days 31 through 60 (IRR, 1.06; 95% CI, 0.97-1.16). The postvaccination risk of BP was consistent across all subgroups stratified by sex, age group, and baseline conditions. Conclusions and Relevance The present self-controlled case series indicated that the risk of BP in individuals older than 65 years increased within the first month, especially within the first week, following fluVc. But overall, the adverse event rate of BP was low, and considering the morbidity and mortality of influenza infection, the benefits of fluVc still outweigh the risks.
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Affiliation(s)
- Chin Hu
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Hwa Wang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Yu-Chia Chang
- Department of Long Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Yu-Tung Huang
- Center for Big Data Analytics and Statistics, Department of Medical Research & Development, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
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Sazak Kundi FC, Paksoy ZB. Association of plasma atherogenic index with the severity and prognosis of Bell's palsy. Acta Otolaryngol 2023; 143:730-734. [PMID: 37610308 DOI: 10.1080/00016489.2023.2248205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND The plasma atherogenic index (AIP) is used as an indicator of cardiovascular risk. Abnormal lipid levels have been shown to potentially contribute to facial nerve inflammation observed in Bell's palsy. This study sought to investigate the association of AIP with the severity and prognosis of Bell's palsy. MATERIAL AND METHODS AIP is calculated using the equation Log (triglyceride [mg/dL]/high-density lipoprotein cholesterol [mg/dL]). The study was conducted prospectively on 79 patients diagnosed with Bell's palsy. The House-Brackmann (H-B) grade was used to determine the severity of Bell's palsy. RESULTS In total, 79 patients [45 (57%) male and 34 (43% female] with Bell's palsy were included to the study. The mean (SD) age was 54.1 (16.5). In multivariable analyses prediction of unrecovered patients, the Odds Ratio (OR) and Confidence Intervals for NLR was 1.322 (1.021-1.797), p = .032, for PLR was 1.100(1.068-1.250), p = .043, for total cholesterol was 1.038 (1.001-1.076), p = .039, for AIP was 4.250 (2.239-8.226), p = .005. The highest area under curve (0.74) was observed for AIP to predict unrecovered Bell's palsy with 71.4% sensitivity and 62.7% specificity. CONCLUSIONS AND SIGNIFICANCES AIP is associated with advanced-stage facial paralysis at the time of Bell's palsy diagnosis and can be used as a poor prognostic indicator.
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Affiliation(s)
- Fatma Cemre Sazak Kundi
- Department of Otorhinolaryngology, Ankara Yildirim Beyazit University, Ankara, Turkey
- Department of Otorhinolaryngology, Ankara City Hospital, Ankara, Turkey
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Liu H, Sun Q, Bi W, Mu X, Li Y, Hu M. Genetic association of hypertension and several other metabolic disorders with Bell's palsy. Front Genet 2023; 14:1077438. [PMID: 37533435 PMCID: PMC10391645 DOI: 10.3389/fgene.2023.1077438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Background: Effects of hypertension, type 2 diabetes and obesity on Bell's palsy risk remains unclear. The aim of the study was to explore whether hypertension and these metabolic disorders promoted Bell's palsy at the genetic level. Methods: Genetic variants from genome-wide association studies for hypertension, type 2 diabetes, body mass index and several lipid metabolites were adopted as instrumental variables. Two-sample Mendelian randomization including IVW and MR-Egger was used to measure the genetic relationship between the exposures and Bell's palsy. Sensitivity analyses (i.e., Cochran's Q test, MR-Egger intercept test, "leave-one-SNP-out" analysis and funnel plot) were carried out to assess heterogeneity and horizontal pleiotropy. All statistical analyses were performed using R software. Results: Hypertension was significantly associated with the increased risk of Bell's palsy (IVW: OR = 2.291, 95%CI = 1.025-5.122, p = 0.043; MR-Egger: OR = 16.445, 95%CI = 1.377-196.414, p = 0.029). Increased level of LDL cholesterol might upexpectedly decrease the risk of the disease (IVW: OR = 0.805, 95%CI = 0.649-0.998, p = 0.048; MR-Egger: OR = 0.784, 95%CI = 0.573-1.074, p = 0.132). In addition, type 2 diabetes, body mass index and other lipid metabolites were not related to the risk of Bell's palsy. No heterogeneity and horizontal pleiotropy had been found. Conclusion: Hypertension might be a risk factor for Bell's palsy at the genetic level, and LDL cholesterol might reduce the risk of the disease. These findings (especially for LDL cholesterol) need to be validated by further studies.
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Affiliation(s)
- Huawei Liu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qingyan Sun
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wenting Bi
- Department of Stomatology, Beijing Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Xiaodan Mu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yongfeng Li
- Department of Stomatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Min Hu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
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'Everybody is watching me': A closer look at anxiety in people with facial palsy. J Plast Reconstr Aesthet Surg 2023; 77:408-415. [PMID: 36638757 DOI: 10.1016/j.bjps.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/09/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Objectives were to evaluate the sociodemographic and disease-related factors, and coping style associated with social interaction and social appearance anxiety in people with unilateral facial palsy. METHODS Medical data were extracted from electronic health records, and participants completed the Social Interaction Anxiety Scale (SIAS), Social Appearance Anxiety Scale (SAAS), and Coping Orientation to Problems Experienced inventory. Associations of SIAS and SAAS scores with sociodemographic and disease variables, and coping were assessed with multiple linear regression. RESULTS Among 111 participants (mean age 58.6 years; 59% women), higher age and greater use of emotion-focused coping were associated with lower SIAS scores, whereas greater use of avoidant coping was associated with higher SIAS scores. Higher age, male sex, and greater use of emotion-focused coping were associated with lower SAAS scores, whereas greater use of avoidant coping was associated with higher SAAS scores. CONCLUSIONS Healthcare providers should understand that women and younger people are more likely to have social appearance concerns and that this is not predicted by the objective severity of facial palsy.
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Efficacy and safety of electric acupuncture in treatment of intractable facial paralysis: A protocol for systematic review and meta-analysis. PLoS One 2022; 17:e0278509. [PMID: 36454980 PMCID: PMC9714806 DOI: 10.1371/journal.pone.0278509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Facial paralysis is a common clinical disease, it was named intractable facial paralysis when the clinical course more than 2 months. Intractable facial paralysis will produce anxiety and depression, which will seriously affect patients' life and work. Electric acupuncture has been widely used in the treatment of intractable facial paralysis. However, the results of clinical studies on the efficacy and safety have been inconsistent. This study aims to evaluate the efficacy and safety of electric acupuncture for intractable facial paralysis patients by systematic review and meta-analysis, so as to provide clinical decision-making based on evidence-based medicine. METHODS The following databases will be searched by electronic methods: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-fang Data and Chinese Biomedical Database. All of them will be retrieved from the establishment date of the electronic database to March 2022, all included studies will be evaluated risk of bias by the Cochrane Handbook. The total effective rate will be the primary outcome. The systematic review will be conducted with the use of the RevMan5.3 software in this study. RESULTS This study will obtain efficacy and safety of electric acupuncture for the treatment of intractable facial paralysis. DISCUSSION This study will provide clinical decision-making based on evidence-based medicine that whether electric acupuncture could be used to treat intractable facial paralysis, and when and how it might be more effective and safety. It will help standardize electric acupuncture treatment strategies for intractable facial paralysis. PROSPERO REGISTRATION NUMBER CRD42021278541.
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Knoedler L, Miragall M, Kauke-Navarro M, Obed D, Bauer M, Tißler P, Prantl L, Machens HG, Broer PN, Baecher H, Panayi AC, Knoedler S, Kehrer A. A Ready-to-Use Grading Tool for Facial Palsy Examiners-Automated Grading System in Facial Palsy Patients Made Easy. J Pers Med 2022; 12:1739. [PMID: 36294878 PMCID: PMC9605133 DOI: 10.3390/jpm12101739] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/15/2022] [Accepted: 10/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The grading process in facial palsy (FP) patients is crucial for time- and cost-effective therapy decision-making. The House-Brackmann scale (HBS) represents the most commonly used classification system in FP diagnostics. This study investigated the benefits of linking machine learning (ML) techniques with the HBS. METHODS Image datasets of 51 patients seen at the Department of Plastic, Hand, and Reconstructive Surgery at the University Hospital Regensburg, Germany, between June 2020 and May 2021, were used to build the neural network. A total of nine facial poses per patient were used to automatically determine the HBS. RESULTS The algorithm had an accuracy of 98%. The algorithm processed the real patient image series (i.e., nine images per patient) in 112 ms. For optimized accuracy, we found 30 training runs to be the most effective training length. CONCLUSION We have developed an easy-to-use, time- and cost-efficient algorithm that provides highly accurate automated grading of FP patient images. In combination with our application, the algorithm may facilitate the FP surgeon's clinical workflow.
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Affiliation(s)
- Leonard Knoedler
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Maximilian Miragall
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Martin Kauke-Navarro
- Department of Surgery, Division of Plastic Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Doha Obed
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, 30625 Hannover, Germany
| | - Maximilian Bauer
- Faculty of Informatics and Data Science, University of Regensburg, 93053 Regensburg, Germany
| | - Patrick Tißler
- Faculty of Informatics and Data Science, University of Regensburg, 93053 Regensburg, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Hans-Guenther Machens
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Peter Niclas Broer
- Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital Munich, 81925 Munich, Germany
| | - Helena Baecher
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Adriana C. Panayi
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Samuel Knoedler
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Andreas Kehrer
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Cole KL, Cole C. A Detailed Account of Severe Bell's Palsy: An Autobiographical Case Report. Cureus 2021; 13:e19837. [PMID: 34963851 PMCID: PMC8702389 DOI: 10.7759/cureus.19837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/22/2022] Open
Abstract
Bell’s palsy is a relatively rare neurologic disorder with a limited selection of helpful therapies. This case report describes the author’s initial three-month experience living with severe Bell’s palsy, including a detailed history and timeline of the initial development of symptoms, treatments pursued, and psychological stress during the disease progression. A particular focus is placed on the emotional burden Bell’s palsy can have, exploring possible avenues to improve physician to patient education on mental health and well-being during initial and delayed recovery.
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Affiliation(s)
- Kyril L Cole
- Neurosurgery, University of Utah School of Medicine, Salt Lake City, USA
| | - Chad Cole
- Neurosurgery, University of New Mexico, Albuquerque, USA
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Thielker J, Kuttenreich AM, Volk GF, Guntinas-Lichius O. [Diagnostics and Therapy of Idiopathic Facial Palsy (Bell's Palsy)]. Laryngorhinootologie 2021; 100:1004-1018. [PMID: 34826861 DOI: 10.1055/a-1529-3582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this review is to report the knowledge for otolaryngologists on standard of care, latest advances, interesting new findings and controversies about the treatment of Bell's palsy. This review is focusing on the acute phase of the disease. The chronic phase, with incomplete, incorrect or no recovery of the palsy, is described briefly. Treatment with prednisolone alone within 72 hours after onset still is the cornerstone of the treatment. The role of antivirals still is unclear. Since 2009 no new and breakthrough clinical trials with influence on the treatment standards have been performed. A study to clarify the role of prednisolone treatment in children is ongoing. Patient-related outcome measures like the Facial Clinimetric Evaluation Scale and the Facial Disability Index are important tools to assess the subjective severity of the disease and psychosocial impact of Bell's palsy next to the motor deficits. Simplified subjective electronic grading systems like the eFACE and first automated image analysis systems have been introduced. Studies clarifying the role of antivirals for severe cases are urgently needed as well as studies on the role of salvage second line therapy after insufficient response to initial corticosteroid treatment. An international consensus on the outcome measures in diagnostics and follow-up is also needed.
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Affiliation(s)
| | | | | | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Jena, Jena, Germany
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Chen G, Li X, Sun M, Zhou Y, Yin M, Zhao B, Li X. COVID-19 mRNA Vaccines Are Generally Safe in the Short Term: A Vaccine Vigilance Real-World Study Says. Front Immunol 2021; 12:669010. [PMID: 34093567 PMCID: PMC8177815 DOI: 10.3389/fimmu.2021.669010] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background The prophylactic vaccination of COVID-19 mRNA vaccines is the first large-scale application of this kind in the human world. Over 1.8 million doses of the COVID-19 vaccine had been administered in the US until December 2020, and around 0.2% submitted AE reports to the Vaccine Adverse Event Reporting System (VAERS). This study aimed to evaluate the AEs following immunization (AEFIs) and analyze the potential associations based on the information from the VAERS database. Methods We searched the VAERS database recorded AEFIs after COVID-19 vaccines in December 2020. After data mapping, we summarized demographic and clinical features of reported cases. Fisher exact test was used to comparing the clinical characteristics among AE groups with an anaphylactic response, concerning neurological disorders and death. Results VAERS reported 3,908 AEFIs of COVID-19 vaccines in December 2020. Most (79.68%) were reported after the first dose of the vaccine. Among the reported cases, we found that general disorders (48.80%), nervous system disorders (46.39%), and gastrointestinal disorders (25.54%) were the most common AEFIs. The allergy history was more frequent in vaccine recipients with anaphylactic reactions than those without (64.91% vs. 49.62%, OR = 1.88, P <0.017). History of anxiety or depression was more common in subjects reporting severe neurological AEFIs than those reporting other AEFIs (18.37% vs. 7.85%, OR = 2.64, P <0.017). Cases reporting death were significantly older (79.36 ± 10.41-year-old vs. 42.64 ± 12.55-year-old, P <0.01, 95% CI 29.30-44.15) and more likely experienced hypertension (50.00% vs. 11.42%, OR = 7.76, P <0.01) and neurological disorders (50.00% vs. 5.36%, OR = 17.65, P <0.01) than other vaccine recipients. The outpatient and emergency room visit rates were 11.92 and 22.42% for AEFIs, and 2.53% of cases needed hospitalization. Conclusion AEFIs of COVID-19 mRNA vaccines were generally non-severe local or systemic reactions. A prior allergy history is the risk factor for anaphylaxis, while a history of anxiety may link with severe neurological AEs. Such vaccine recipients need further evaluation and monitor.
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Affiliation(s)
- Gang Chen
- Nephrology Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaolin Li
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Meixing Sun
- Nephrology Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yangzhong Zhou
- Nephrology Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Meifang Yin
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Zhao
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuemei Li
- Nephrology Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Cao Z, Jiao L, Wang H, Li J, Zhong G, Zhu D, Xu W, Jin M. The efficacy and safety of cupping therapy for treating of intractable peripheral facial paralysis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25388. [PMID: 33879669 PMCID: PMC8078480 DOI: 10.1097/md.0000000000025388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/14/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Peripheral facial paralysis (PFP) is a common clinical neurological disease and the incidence of intractable peripheral facial paralysis is on the rise. Symptoms include crooked mouth and eyes, tearing and shallow nasolabial folds. The disease seriously affects the physical and mental health of patients. At present, a large number of clinical studies have shown that cupping is effective in treating intractable peripheral facial paralysis (IPFP). Therefore, the purpose of this review is to evaluate the effectiveness and safety of cupping in the treatment of refractory peripheral facial paralysis. METHODS We will conduct a comprehensive and systematic search of relevant documents in the following databases: Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure (CNKI), Wang Fang Database, Chinese Scientific Journal Database from inception to February 2021 without any language restriction. The 2 reviewers will be independently completed select research, extract data, evaluate research quality and use the Cochrane risk of bias tool to assess methodological quality. Using revman5.4 software for statistical analysis. The degree of heterogeneity will be Determined through heterogeneity test, to definite whether to adopt a random effects model or a fixed-effects model. RESULTS The protocol for the meta-analysis will systematically evaluate the efficacy and safety of cupping therapy for intractable peripheral facial paralysis patients. CONCLUSION This study will explore whether or not cupping therapy can be used as one of the non-drug therapies to prevent or treat intractable peripheral facial paralysis.
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Affiliation(s)
- Zhiwen Cao
- Jiangxi University of Traditional Chinese Medicine
| | - Lin Jiao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Hongyu Wang
- Jiangxi University of Traditional Chinese Medicine
| | - Jun Li
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Genping Zhong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Daocheng Zhu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Wei Xu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - MengKe Jin
- Jiangxi University of Traditional Chinese Medicine
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Cuenca-Martínez F, Zapardiel-Sánchez E, Carrasco-González E, La Touche R, Suso-Martí L. Assessing anxiety, depression and quality of life in patients with peripheral facial palsy: a systematic review. PeerJ 2020; 8:e10449. [PMID: 33344085 PMCID: PMC7718791 DOI: 10.7717/peerj.10449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Peripheral facial palsy (PFP) is predominantly a unilateral disorder of the facial nerve, which can lead to psychological disorders that can result in decreased quality of life. The aim of this systematic review was to assess anxiety, depression and quality of life symptoms associated with PFP. DATA SOURCES We searched the Medline, PEDro, CINAHL and Google Scholar databases to conduct this systematic review while following Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. The search was performed by two independent reviewers, and differences between the two reviewers were resolved by consensus. STUDY SELECTION The search terms used were derived from the combination of the following MeSH terms: "facial paralysis", "bell palsy", "anxiety", "anxiety disorders", "depression", "depressive disorders", "quality of life" and not MeSH: "facial palsy", "hemifacial paralysis", "facial paresis", "Peripheral Facial Paralysis", using the combination of different Boolean operators (AND/OR). DATA EXTRACTION On November 1st (2019). DATA SYNTHESIS In total, 18 cross-sectional articles and two case-control studies were selected. CONCLUSIONS The cross-sectional articles showed low methodological quality, while the case-control studies showed acceptable methodological quality. Limited evidence suggests that patients with PFP might have increased levels of anxiety and depressive symptoms. A qualitative analysis also showed limited evidence that quality of life might be diminished in patients with PFP. PROSPERO CRD42020159843.
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Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Eva Zapardiel-Sánchez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Enrique Carrasco-González
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
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13
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Inagaki A, Takahashi M, Murakami S. Facial and hearing outcomes in transmastoid nerve decompression for Bell's palsy, with preservation of the ossicular chain. Clin Otolaryngol 2020; 46:325-331. [PMID: 33236466 PMCID: PMC7983904 DOI: 10.1111/coa.13671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/04/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
Objectives Facial nerve decompression is a salvage treatment for Bell's palsy patients for whom a poor prognosis is anticipated with standard medical treatment. The transmastoid approach is a frequently performed approach, but it remains unknown if this surgery is effective when the ossicular chain is preserved. This study aimed to determine the efficacy of facial nerve decompression using the transmastoid approach in Bell's palsy. Design, setting and participants This retrospective study included patients who had undergone transmastoid facial nerve decompression with ossicular chain preservation and patients who met the criteria for surgery, but received only medical treatment between January 2007 and May 2019, at a single centre. Main outcome measures Attainment of House‐Brackmann grade I at 12 months after onset of facial palsy. Results The recovery rate to House‐Brackmann grade I in the decompression group in the early phase (≤18 days after onset) was higher than that of the medical treatment group, although the difference was not significant (70% vs 47%, P = .160). However, within this early surgery group, a subgroup of cases with ≥95% facial nerve degeneration demonstrated a significant improvement in recovery rate (73% vs 30%, P = .018). Among surgeries performed in the late phase (≥19 days), only a subgroup with ≥95% facial nerve degeneration was available for analysis, and the difference in recovery rate was not significant compared with medical treatment alone (26% vs 30%, P = 1.00). Post‐surgical hearing evaluation demonstrated that average hearing deterioration was 1.3 dB which was non‐significant, suggesting this procedure does not cause hearing loss. Conclusions Transmastoid facial nerve decompression with ossicular chain preservation in the early phase after symptom‐onset is an effective salvage treatment for severe Bell's palsy with ≥95% facial nerve degeneration.
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Affiliation(s)
- Akira Inagaki
- Departments of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
| | - Mariko Takahashi
- Departments of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
| | - Shingo Murakami
- Departments of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
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Magazi D, Longombenza B, Mda S, Van der Meyden K, Motshwane M, Nanjoh M, Towobola O. HIV infection, seasonality and younger age predicting incident Bell's palsy among black South Africans. BMC Neurol 2020; 20:381. [PMID: 33087095 PMCID: PMC7576736 DOI: 10.1186/s12883-020-01965-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 10/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Although South Africa (SA) is facing a high prevalence of HIV infection, there is no literature from this region on a link between Bell’s palsy and HIV. The aim of this study was to identify the occurrence of Bell’s palsy in relation to demographics, seasons and HIV status among black South Africans. Methods This retrospective cohort was conducted among adult black patients, without Bell’s palsy in 2003, presenting to the neurology outpatients department at Dr. George Mukhari Academic hospital, Pretoria, South Africa, between 2004 (study baseline) and 2012 (end test). Gender, age, HIV status, and seasons were potential predictors of Bell’s palsy using Cox regression model and Kaplan Meier curves. Results From the baseline of 1487 patients, 20.9% (n = 311) experienced Bell’s palsy onset by the end of the study. In univariate analysis, male gender (RR = 2.1 95% CI 1.7–2.5; P < 0.0001), age less than 30 years (RR = 2.9 95% CI 2.4–3.6; P < 0.0001), HIV seropositivity (RR =2.9 95% CI 2.3–4.9; P < 0.0001). The highest incidence in winter (30.3% n = 136/450) vs. incidences during other seasons with Intermediate values during Summer (25.3% n = 136/450) and Autumn (20.7% n = 64/308) and the lowest incidence in Spring (23.7% n = 16/353) P < 0.0001) were predictors of Bell’s palsy. In multivariate analysis at adjusting for gender, the most significant and independent predictors of incident Bell’s palsy were HIV seropositivity (HR = 6.3 95% CI 4.8–8.3; P < 0.0001), winter (HR = 1.6 95% CI 1.2–2.1; P < 0.0001) vs. other seasons, and younger age < 30 years (HR = 7.1 95% CI 5.6–9.1; P < 0.0001) vs. older age groups. Conclusion Seasonality, younger age and HIV positivity are important and independent risk factors of Bell’s palsy. Education and awareness programs on the possible effects of HIV and seasons on the development of Bell’s palsy are necessary. This would lead to a better understanding and even a possible development of avoidance measures for this condition amongst young black South Africans.
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Affiliation(s)
- Dali Magazi
- Department of Neurology, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
| | - Benjamin Longombenza
- Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Siyazi Mda
- Department of Paediatrics, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Kees Van der Meyden
- Department of Neurology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Marcus Motshwane
- Department of statistics, Tshwane University of technology, Pretoria, South Africa
| | - Mirabel Nanjoh
- Faculty of health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Olakunle Towobola
- Department of Internal Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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15
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Zammit M, Markey A, Webb C. A rise in facial nerve palsies during the coronavirus disease 2019 pandemic. J Laryngol Otol 2020; 134:1-4. [PMID: 32998780 PMCID: PMC7542321 DOI: 10.1017/s0022215120002121] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE An increase in spontaneous lower motor neuron facial nerve (VIIth cranial nerve) palsies was seen during the severe acute respiratory syndrome coronavirus 2 outbreak in our emergency clinic. This led us to perform a single-centre cohort review. METHODS A retrospective review was conducted of VIIth cranial nerve palsies from January to June 2020 and the findings were compared to those cases reviewed in the previous year. The severe acute respiratory syndrome coronavirus 2 incidence of the cohort was compared with that of the Liverpool population. RESULTS Our VIIth cranial nerve palsy incidence in the 2020 period was 3.5 per cent (30 out of 852), 2.7 higher than last year's rate of 1.3 per cent (14 out of 1081), which was a statistically significant difference (p < 0.01). Two of the 17 patients in our cohort tested positive for severe acute respiratory syndrome coronavirus 2 (11.8 per cent), contrasting with Liverpool's severe acute respiratory syndrome coronavirus 2 incidence (0.5 per cent). CONCLUSION Severe acute respiratory syndrome coronavirus 2 may be responsible for an increased number of facial nerve palsies; it is important for clinicians to be aware that this may being an initial presentation of the disease.
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Affiliation(s)
- M Zammit
- ENT Department, Broadgreen Hospital, Liverpool, UK
| | - A Markey
- ENT Department, Broadgreen Hospital, Liverpool, UK
| | - C Webb
- ENT Department, Broadgreen Hospital, Liverpool, UK
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Fricain M, Moreau N. Lockdown-related idiopathic facial paralysis: illustration of an indirect victim of the COVID-19 pandemic? JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: In the midst of the COVID-19 pandemic, there are numerous reports of SARS-CoV-2-related symptoms in many medical subspecialties. Unfortunately, there seems to be little focus on indirect victims of COVID-19, such as diseases/ailments secondary to COVID-19-related lockdown in relevant countries. Observation: We report a case of idiopathic facial paralysis (Bell's Palsy) that occurred in an otherwise-healthy 49-year-old French chef during nationwide lockdown, possibly fostered by severe concerns regarding his professional prospects. Other manifestations of severe anxiety were also observed such as tension-type headache and psoriasis outbreaks. Prednisone and valaciclovir were initiated, in association with simple counselling. Commentary and conclusion: As HSV-1 reactivation in the facial nerve is suspected in the pathophysiology of idiopathic facial paralysis, this case could constitute an example of lockdown-related disease and an illustration of indirect manifestations of the COVID-19 pandemic. Such indirect diseases are likely to increase as the pandemic continues to take its toll both medically and socio-economically.
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Hotton M, Huggons E, Hamlet C, Shore D, Johnson D, Norris JH, Kilcoyne S, Dalton L. The psychosocial impact of facial palsy: A systematic review. Br J Health Psychol 2020; 25:695-727. [PMID: 32538540 DOI: 10.1111/bjhp.12440] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/11/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Facial palsy is a condition which can lead to significant changes in facial function and appearance. People with facial palsy often report psychosocial difficulties, including withdrawal from social activities, anxiety, negative body image, and low mood. This paper aimed to review all published research investigating the psychosocial impact of facial palsy on adults. METHODS A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, and AMED databases was performed. The quality of included studies was assessed, and data were extracted with regard to characteristics of participants; study methodology and design; outcome measures used; and psychosocial outcomes. RESULTS Twenty-seven studies met inclusion criteria. A high proportion of people with facial palsy reported clinically significant levels of anxiety and depression, with greater difficulties typically reported by females, compared to males. Other difficulties consistently reported include low quality of life, poor social function, and high levels of appearance-related distress. Objective severity of facial palsy was consistently shown to not be associated with anxiety or depression, with psychological factors instead likely mediating the relationship between the severity of facial palsy and psychosocial well-being. CONCLUSIONS Irrespective of objective symptom severity, facial palsy has the potential to have a significant impact on psychosocial well-being and quality of life. The various methodological limitations of the included studies are discussed, along with clinical implications, including the need for greater access to psychological screening and interventions for people with facial palsy.
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Affiliation(s)
- Matthew Hotton
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Esme Huggons
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Claire Hamlet
- Centre for Appearance Research, University of the West of England, UK
| | - Danielle Shore
- Department of Experimental Psychology, University of Oxford, UK
| | - David Johnson
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Jonathan H Norris
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Sarah Kilcoyne
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
| | - Louise Dalton
- Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK
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Li B, Sun X, Guo J, Shu W, Cheng Y, Li J. Effectiveness comparisons of acupuncture treatments for Bell palsy in adults: A protocol for systematic review and Bayesian network meta-analysis. Medicine (Baltimore) 2020; 99:e20252. [PMID: 32501973 PMCID: PMC7306354 DOI: 10.1097/md.0000000000020252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Bell palsy (BP) is a simple peripheral facial paralysis. A variety of acupuncture treatments have been reported effective for the recovery of BP. However, the relative effectiveness of these acupuncture treatments is still unclear. Therefore, we plan to summarize the evidence and determine the most effective acupuncture treatment for BP. METHODS We will search the following database, including The Cochrane Library, PubMed, Web of Science, EMBASE, China BioMedical Literature (CBM),China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang database, from their inceptions to April 30, 2020, in order to collect randomized controlled trials (RCTs) on acupuncture in the treatment of BP. We will use Stata16.0 and WinBUGS software for statistical analysis and draw surface under the cumulative ranking curve (SUCRA) graph for each outcome indicator to predict the order of curative effect of treatment measures. RESULTS This study will compare and rank the effectiveness of different acupuncture methods in the treatment of BP, and the outcome indicators will include House-Brackmann Grading Scale, sequelae, Facial Disability Index score, Sunnybrook facial grading system, Portmann score, and adverse events. CONCLUSION Our study will provide supports for clinical practice.INPLASY registration number: INPLASY202040019.
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Affiliation(s)
- Bing Li
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Xiqing Sun
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Jun Guo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, PR China
| | - Wenjie Shu
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Yiran Cheng
- Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Jie Li
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
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Lee SY, Kong IG, Oh DJ, Choi HG. Increased risk of depression in Bell's palsy: Two longitudinal follow-up studies using a national sample cohort. J Affect Disord 2019; 251:256-262. [PMID: 30933749 DOI: 10.1016/j.jad.2019.03.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/11/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recently, a bidirectional association between Bell's palsy and anxiety disorders has been reported. Given the common comorbidity between anxiety and depressive conditions and the typical developmental trajectory of anxiety before depression, we hypothesized that the bidirectional association between Bell's palsy and depression is also reproducible. METHODS Using data from the Korean National Health Insurance Service-National Sample Cohort, data were collected from 3,526 Bell's palsy patients who were 1:4 matched by age, sex, income, region of residence, and past medical history with 14,104 controls. Additionally, 61,068 depression patients were matched with 244,272 control participants. A Cox proportional hazards model was used to analyze the hazard ratio (HR) of Bell's palsy for depression (study I) and depression for Bell's palsy (study II). RESULTS In study I, the adjusted HR for depression was 1.41 (95% confidence interval [CI] = 1.20-1.66) in the Bell's palsy group (P < 0.001). In subgroup analyses, an increased risk of depression was more evident, particularly in female participants ≥ 40 years old. This association was evident in follow-up periods 6 months after the index date. In study II, the adjusted HR for Bell's palsy was 1.08 (95% CI = 0.94-1.25) in the depression group (P = 0.280). CONCLUSION A history of Bell's palsy increased the risk of depression. Contrary to our hypotheses, depression did not increase the risk of Bell's palsy.
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Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Il Gyu Kong
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Dong Jun Oh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo Geun Choi
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, South Korea.
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Kim SY, Lee CH, Lim JS, Kong IG, Sim S, Choi HG. Increased risk of Bell palsy in patient with migraine: A longitudinal follow-up study. Medicine (Baltimore) 2019; 98:e15764. [PMID: 31124964 PMCID: PMC6571209 DOI: 10.1097/md.0000000000015764] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Migraine is thought to be associated with Bell palsy. This study aimed to investigate the risk of Bell palsy in migraine patients.The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. A total of 45,164 migraine patients were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia and compared with 180,656 controls. The migraine group included participants diagnosed with migraine [International Classification of Disease (ICD)-10: G43] who underwent treatment more than once. Participants with Bell palsy were included on the basis of the ICD-10 (G510) and treatment with steroids. A history of hypertension, diabetes, and dyslipidemia was determined using ICD-10 codes. Crude (simple) and adjusted hazard ratios (HRs) of Bell palsy in migraine patients were analyzed using the Cox proportional hazards model. Subgroup analyses were conducted based on age and sex.Bell palsy occurred in 0.6% (262/44,902) of the migraine group and 0.5% (903/179,753) of the control group. The adjusted HR of Bell palsy was 1.16 in the migraine group compared with the control group [95% confidence interval (95% CI) = 1.01-1.33, P = .34]. Among age-related subgroups, participants ≥30 and <60 years old in the migraine subgroup demonstrated a 1.28-times higher risk of Bell palsy than the control group (95% CI = 1.05-1.57, P = .014).Migraine increased the risk of Bell palsy in the total population. Among age subgroups, migraine patients ≥30 and <60 years old had an increased risk of Bell palsy.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | - Chang-Ho Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang
| | - Il Gyu Kong
- Department of Statistics, Hallym University, Chuncheon
| | - Songyong Sim
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Statistics, Hallym University, Chuncheon
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Abstract
Bell’s palsy is the most common condition involving a rapid and unilateral onset of peripheral paresis/paralysis of the seventh cranial nerve. It affects 11.5–53.3 per 100,000 individuals a year across different populations. Bell’s palsy is a health issue causing concern and has an extremely negative effect on both patients and their families. Therefore, diagnosis and prompt cause determination are key for early treatment. However, the etiology of Bell’s palsy is unclear, and this affects its treatment. Thus, it is critical to determine the causes of Bell’s palsy so that targeted treatment approaches can be developed and employed. This article reviews the literature on the diagnosis of Bell’s palsy and examines possible etiologies of the disorder. It also suggests that the diagnosis of idiopathic facial palsy is based on exclusion and is most often made based on five factors including anatomical structure, viral infection, ischemia, inflammation, and cold stimulation responsivity.
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Thielker J, Geißler K, Granitzka T, Klingner CM, Volk GF, Guntinas-Lichius O. Acute Management of Bell’s Palsy. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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