A clinical study of etiology and management of Bell's palsy in a Tertiary Care Hospital

Abstract

Bell's palsy is a common presentation in Otolaryngology practice. The aim of the present study to find the etiology and management of patients with Bell's palsy presenting to the Department of Otolaryngology in a tertiary care hospital. Methods: This prospective cross-sectional study was carried out in the Department of ENT, Rajiv Gandhi Institute of Medical Sciences [RIMS], Adilabad from September 2017 to Jan 2019. A total of n=67 patients n=26 male and n=41 females were included in the study. After complete history and clinical evaluation an initial dose of oral prednisolone 60mg/day in three divided doses for 7 days followed by tapering off within the next five days by 10mg/day reduction in a single-dose regimen. Advised serial follow up at the end of 1 st , 2 nd , 3 rd and 6 th week followed by 3 months and 6 months. Results: The grading of facial paresis was carried as per House-Brackmann scale most of the patients n=33(49.25%) were detected with Grade II mild dysfunctions. Followed by moderate dysfunction grade III in n=15(22.39%). Grades IV and V having n=7(10.45%) each and grade VI in n=5(7.46%). The majority patients were given steroids n=36(53.73%) and steroids along with physiotherapy n=15(22.39%), NSAID n=21(31.34%), vitamin B12 n=22(32.84%) and antiviral were for n=10 (14.92%). Conclusion: The present study concludes that females are more commonly affected by Bell's palsy and the age group more affected is 30 -40 years. Recurrence of Bell's palsy was also noted in some cases. Most of our patients responded to prednisolone and antiviral treatment, some were prescribed only steroids with physiotherapy. From our experience, we can assume that the treatment of Bell's palsy should be based on the etiology and needs of the patients and most of the cases will recover within acceptable limits.