Intratympanic steroid injection for Bell's palsy: preliminary randomized controlled study.

OBJECTIVE

To investigate adjuvant effect and safety of intratympanic steroid for the treatment of Bell's palsy.

STUDY

DESIGN

Prospective, investigator blinded, randomized study.

SETTING

Tertiary referral center.

PATIENTS: Patients who received treatment for Bell's palsy from December 2007 to March 2011 were randomly divided into two groups. The control group (n = 17) was treated with systemic steroid plus antiviral agent, and intratympanic steroid injection group (IT group, n = 14) received intratympanic steroid injection combined with medications. Facial functions were evaluated on a regular basis up to 6 months.

INTERVENTION: Intratympanic steroid injection.

MAIN OUTCOME MEASURES: Facial nerve functions of initial presentation and follow-up were evaluated with House-Brackmann (H-B) system. Primary outcome was complete recovery rate of 6 months. Secondary outcomes included improvement of H-B grade within 3 weeks, time of first improvement in facial function, and cumulative recovery rate. In addition, subgroup analysis of H-B grade over than IV was performed.

RESULTS

Complete recovery rate was not different between groups. Time of first improvement was shorter in IT group (p = 0.043). And IT group had a better cumulative recovery rate (p = 0.041) and showed the significant improvement in H-B grade within 3 weeks compared with control group (p = 0.045). In severe facial palsy, complete recovery rate of IT group and control group were 80% and 50% (p = 0.16), and IT groups showed the significant facial improvement within 3 weeks (p = 0.025). And there were no major adverse effects of intratympanic injection.

CONCLUSION

Intratympanic steroid injection might be a safe and useful adjuvant treatment modality for Bell's palsy.