Use of Corticosteroids in Children with Bell's Palsy: A Systematic Review and Meta-Analysis

Importance: Corticosteroids are recommended as first-line treatment for adults with acute Bell's palsy, but their role in children remains uncertain. Objective: To assess the effect of corticosteroid therapy on recovery rates in children with acute Bell's palsy. Evidence Review: PubMed, Scopus, and Cochrane Library were systematically searched from inception to April 2, 2025, for studies on corticosteroids for children with Bell's palsy. Odds ratios and risk ratios with 95% confidence intervals were pooled using R software (version 4.2.3). Risk of bias was assessed with RoB2 and ROBINS-I. Findings: Eleven studies were included, comprising 750 children, of whom 495 (66%) received corticosteroids. The analysis across final follow-ups showed no significant difference. Because follow-ups ranged from 1 to 24 months, 1, 3, and 6 months were used as key points to create comparable intervals. The following subgroups were analyzed for each interval: corticosteroid monotherapy and corticosteroids plus adjunctive therapy. Corticosteroid monotherapy was associated with higher complete recovery rates beyond 1 month and a lower risk of incomplete recovery after 6 months. Conclusions and Relevance: Corticosteroid monotherapy in children with acute Bell's palsy may improve recovery rates beyond the first month, supporting its implementation in treatment protocols.