Early Prognostic Markers for Idiopathic Facial Palsy

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Autores principales: Miguel Vaca, Belén Alonso, Rubén Polo, María del Mar Medina, Adela Cordero, Cecilia Pérez, Gonzalo de los Santos
Formato: Artículo Open Access
Publicado: Wiley 2025
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author Miguel Vaca
Belén Alonso
Rubén Polo
María del Mar Medina
Adela Cordero
Cecilia Pérez
Gonzalo de los Santos
author_facet Miguel Vaca
Belén Alonso
Rubén Polo
María del Mar Medina
Adela Cordero
Cecilia Pérez
Gonzalo de los Santos
Miguel Vaca
Belén Alonso
Rubén Polo
María del Mar Medina
Adela Cordero
Cecilia Pérez
Gonzalo de los Santos
collection Wiley Open Access
contents Early Prognostic Markers for Idiopathic Facial Palsy Miguel Vaca Belén Alonso Rubén Polo María del Mar Medina Adela Cordero Cecilia Pérez Gonzalo de los Santos The Laryngoscope ObjectivesTo analyze the prognostic value of markers available at the onset of idiopathic facial palsy. To define the evolution of the episode by tracing changes in facial function over time.MethodsThis is an observational prospective study on patients with facial palsy consulting in the first 24 hs. The evolution was recorded with photographs and monthly visits. Multivariate analysis was conducted between clinical and analytical parameters determined in the first visit and prognostic outcomes: progression, resolution, and “facial palsy evolution index,” which integrates severity of the palsy and duration.ResultsSixty‐five patients were included. The mean initial HB grade was III, but 31% of the cases progressed in the following days. Complete recovery was observed in 89.5% of the cases (mean duration of the episode of 48 days), and exposure keratitis in 21.5%, with a mean of 42 days after the onset. Multivariate analysis showed that retroauricular pain and white blood cell count were significantly related to progression (odds ratio [OR] 19.08; 1.49, p < 0.05), incomplete resolution (OR 1/0.04; 1/0.59, p < 0.05), and higher evolution index (12.8; 2.9, p < 0.05). Age was also significantly associated with evolution index (0.27, p < 0.05), and platelet‐to‐lymphocyte ratio with progression (OR 1.02, p < 0.05). The rest of the parameters did not show an association with prognosis.ConclusionsRetroauricular pain and white blood cell count are early indicators of prognosis in idiopathic facial palsy. Initial examinations may not reflect the maximum grade of weakness reached by the patient. Ocular complications can occur several weeks after the onset, even with mild grades of paralysis.Level of Evidence3 Laryngoscope, 135:1964–1969, 2025 10.1002/lary.32022 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/lary.32022
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institution Wiley Open Access
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publishDate 2025
publisher Wiley
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spellingShingle Early Prognostic Markers for Idiopathic Facial Palsy
Miguel Vaca
Belén Alonso
Rubén Polo
María del Mar Medina
Adela Cordero
Cecilia Pérez
Gonzalo de los Santos
The Laryngoscope
Early Prognostic Markers for Idiopathic Facial Palsy Miguel Vaca Belén Alonso Rubén Polo María del Mar Medina Adela Cordero Cecilia Pérez Gonzalo de los Santos The Laryngoscope ObjectivesTo analyze the prognostic value of markers available at the onset of idiopathic facial palsy. To define the evolution of the episode by tracing changes in facial function over time.MethodsThis is an observational prospective study on patients with facial palsy consulting in the first 24 hs. The evolution was recorded with photographs and monthly visits. Multivariate analysis was conducted between clinical and analytical parameters determined in the first visit and prognostic outcomes: progression, resolution, and “facial palsy evolution index,” which integrates severity of the palsy and duration.ResultsSixty‐five patients were included. The mean initial HB grade was III, but 31% of the cases progressed in the following days. Complete recovery was observed in 89.5% of the cases (mean duration of the episode of 48 days), and exposure keratitis in 21.5%, with a mean of 42 days after the onset. Multivariate analysis showed that retroauricular pain and white blood cell count were significantly related to progression (odds ratio [OR] 19.08; 1.49, p < 0.05), incomplete resolution (OR 1/0.04; 1/0.59, p < 0.05), and higher evolution index (12.8; 2.9, p < 0.05). Age was also significantly associated with evolution index (0.27, p < 0.05), and platelet‐to‐lymphocyte ratio with progression (OR 1.02, p < 0.05). The rest of the parameters did not show an association with prognosis.ConclusionsRetroauricular pain and white blood cell count are early indicators of prognosis in idiopathic facial palsy. Initial examinations may not reflect the maximum grade of weakness reached by the patient. Ocular complications can occur several weeks after the onset, even with mild grades of paralysis.Level of Evidence3 Laryngoscope, 135:1964–1969, 2025 10.1002/lary.32022 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Early Prognostic Markers for Idiopathic Facial Palsy
topic The Laryngoscope
url https://onlinelibrary.wiley.com/doi/10.1002/lary.32022