Original ResearchDoes Type 2 Diabetes Mellitus Affect the Healing of Bell's Palsy in Adults?
Introduction
Bell's palsy (BP) (idiopathic unilateral facial paralysis) is the most common cause of acute nontraumatic peripheral facial palsy (1). The annual incidence of BP is 15 to 30 per 100,000 subjects, and equal numbers of males and females are affected 1, 2.
Approximately 70% of patients with BP recover completely without any treatment (3); with treatment, the rate rises to 90% (4). Many factors have been suggested as contributors to the healing process of BP. The most remarkable of these factors is diabetes. There is a common belief that diabetes affects the healing process of BP negatively. Although a relationship between diabetes and BP has been suggested, controlled studies are few in number. We explored whether diabetes affects the healing of BP.
Section snippets
Methods
This was a retrospective case-control study approved by our ethics committee (#2015-107-04/11). The study was conducted in an otolaryngology clinic between October 2012 and October 2014. We enrolled 60 patients who complained of facial paralysis and were diagnosed with BP; they visited our clinic regularly during the first week after diagnosis. Each patient underwent a complete ear, nose and throat examination, a neurologic examination, routine blood testing (including blood sugar and glycated
Results
The patients with diabetes were between 47 and 76 years of age (mean, 62.8±8.79 years). The patients without diabetes were 25 to 70 years of age (mean, 47.5±13.11 years); the mean age differed significantly in the 2 groups (p<0.001). The group with diabetes contained 12 (40%) women and 18 (60%) men; the group without diabetes included 16 (53.3%) men and 14 (46.6%) women. The recovery times did not differ in the 2 groups (p=0.438). We found no relationship between age and recovery time
Discussion
A number of factors supposedly affecting the prognosis of BP have been studied; they include age, sex, the side affected, hypertension, hypercholesterolemia and diabetes. The most controversial of these factors is diabetes. Takemoto et al found an association between diabetes and lack of recovery (6). Kanazawa et al found that although the healing process of patients with diabetes was similar to that of those without diabetes for the first month, healing was notably slower in patients with
Results
Our study had certain limitations. Our patient numbers were low, and the 2 groups differed in terms of mean age. To minimize this imbalance, we included only the oldest patients without diabetes. However, further work with more patients and groups that are better balanced in terms of age is required.
Conclusions
Diabetes did not significantly affect the severity or healing rate of BP or the recovery rate. A possible influence of steroid therapy on BP development in patients with diabetes should be considered; such patients should be closely monitored.
Author Disclosures
Conflicts of interest: None.
References (20)
- et al.
Electrophysiological findings of acute peripheral facial palsy in diabetic and non-diabetic patients
Neurosci Lett
(2007) - et al.
Peripheral neuropathy in patients with diabetes mellitus presenting as Bell's palsy
Neurosci Lett
(2007) Clinical practice: Bell's palsy
N Engl J Med
(2004)- et al.
Annualized incidence and spectrum of illness from an outbreak investigation of Bell's palsy
Neuroepidemiology
(2002) Bell's palsy: The spontaneous course of 2500 peripheral facial nerve palsies of different etiologies
Acta Otolaryngol Suppl
(2002)- et al.
Corticosteroids for Bell's palsy (idiopathic facial paralysis)
Cochrane Database Syst Rev
(2010) - et al.
Facial nerve grading system
Otolaryngol Head Neck Surg
(1985) - et al.
Prognostic factors of peripheral facial palsy: Multivariate analysis followed by receiver operating characteristic and Kaplan-Meier analyses
Otol Neurotol
(2011) - et al.
Prognosis for Bell's palsy: A comparison of diabetic and nondiabetic patients
Acta Otolaryngol
(2007) - et al.
Disorders of the facial nerve
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2023, Brazilian Journal of OtorhinolaryngologyCitation Excerpt :Kanazawa et al.23 found no significant differences between pre-treatment and 1-month post-treatment HB stages in BP patients with and without DM. Similarly, Eliçora et al.24 reported that DM had no effect on BP recovery time. The improvement in diabetic BP patients was found to be similar to that in non-diabetic BP patients, similar to the findings of the present study.
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2024, CNS and Neurological Disorders - Drug TargetsPrevalence of facial nerve palsy in the neuro-medicine private clinic
2023, Romanian Journal of Neurology/ Revista Romana de NeurologieAssociation between initial severity of facial weakness and outcomes of bell’s palsy
2021, Journal of Clinical MedicineEvaluation of effects of diabetes mellitus, hypercholesterolemia and hypertension on bell’s palsy
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