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

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Bell's palsy is a common neurological disorder causing sudden facial paralysis.
• Current treatments include systemic steroids and antiviral agents, with varying recovery rates.
• Adjuvant therapies are being explored to improve outcomes and expedite recovery.

Purpose of the Study:

• To evaluate the efficacy and safety of intratympanic steroid injections as an adjuvant treatment for Bell's palsy.
• To compare the recovery rates and facial function improvement between intratympanic steroid injection and conventional treatment.

Main Methods:

• A prospective, investigator-blinded, randomized study was conducted at a tertiary referral center.
• Patients were divided into a control group (systemic steroid + antiviral) and an intratympanic (IT) steroid injection group.
• Facial nerve function was assessed using the House-Brackmann (H-B) system for up to 6 months.

Main Results:

• The intratympanic steroid group demonstrated a significantly shorter time to first facial function improvement (p=0.043).
• The IT group also showed a better cumulative recovery rate (p=0.041) and significant H-B grade improvement within 3 weeks (p=0.045).
• In severe cases, the IT group had a higher complete recovery rate (80% vs. 50%) and faster improvement within 3 weeks (p=0.025), with no major adverse effects.

Conclusions:

• Intratympanic steroid injection is a safe and potentially beneficial adjuvant therapy for Bell's palsy.
• This approach may accelerate facial function recovery, particularly in severe cases.
• Further research can explore optimal protocols and long-term efficacy.