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Association Between Prednisone and Delayed Facial Nerve Palsy After Acoustic Neuroma Resection
Shahid Iqbal1, Saad Illahi2, Oktay Genel3
1Department of Otolaryngology-Head and Neck Surgery, University of California San Diego, La Jolla, California, USA.
The Laryngoscope
|June 12, 2026
Summary
Discharge with a prednisone taper did not reduce delayed facial nerve palsy after acoustic neuroma resection. Prophylactic steroid use is not supported for preventing this complication.
Area of Science:
- Neurosurgery
- Otolaryngology
- Neurology
Background:
- Delayed facial nerve palsy (DFP) is a potential complication following acoustic neuroma resection.
- Corticosteroids are sometimes used to mitigate postoperative nerve dysfunction.
Purpose of the Study:
- To determine if a prednisone taper at discharge reduces DFP incidence after acoustic neuroma resection.
Main Methods:
- Retrospective, weighted case-control study.
- Included patients with normal preoperative and discharge facial nerve function (House-Brackmann grade I).
- Used inverse probability weighting (IPW) to adjust for confounding factors.
Main Results:
- Prednisone taper was not associated with a reduced risk of DFP after IPW adjustment (OR 0.99, 95% CI: 0.48-2.07).
- Covariate balance was achieved post-weighting.
- Steroid side effects were reported in 10% of patients receiving the taper.
Conclusions:
- Discharge with a prednisone taper does not decrease the incidence of DFP post-acoustic neuroma resection.
- Findings do not support routine prophylactic corticosteroid use for DFP prevention.
