Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India

Introdutcion: Idiopathic palsy of facial nerve is an acute disease which causes lower motor neuron palsy characterised by facial asymmetry leads to psychological effects and limits one’s social life. Steroids are very effective in the management of Bell’s palsy. The usage of antiviral is still in de...

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Main Authors: SR Kartrthika, K Priya, S Rajasekaran, D Balaji
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2023-01-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/17201/56306_CE(AD)_F[SK]_PF1(SC_SH_KM)_PFA(SC_KM)_PN(KM).pdf
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author SR Kartrthika
K Priya
S Rajasekaran
D Balaji
author_facet SR Kartrthika
K Priya
S Rajasekaran
D Balaji
author_sort SR Kartrthika
collection DOAJ
description Introdutcion: Idiopathic palsy of facial nerve is an acute disease which causes lower motor neuron palsy characterised by facial asymmetry leads to psychological effects and limits one’s social life. Steroids are very effective in the management of Bell’s palsy. The usage of antiviral is still in debate due to the idiopathic aetiology of Bell’s palsy. Aim: To evaluate the efficacy of acyclovir with steroid and steroid alone in the management of Bell’s palsy with respect to the recovery time. Materials and Methods: The randomised double-blinded study was conducted in the Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India, from September 2021 to February 2022 among 100 patients with idiopathic facial nerve palsy. Patients were divided into two groups, 50 patients in each. One group treated with acyclovir (400 mg oral five times daily) and methylprednisolone (1 mg/kg/day), and other group treated with steroid alone. Both the groups received physiotherapy in the Department of Physiotherapy and taught about home facial exercises. The patients were on regular follow-up for 6 months to monitor the time of the recovery. House-Brackmann grading system was used for initial assessment and monitor the recovery of the patient. The improvement of House-Brackmann grade to I or II was considered a satisfactory recovery. The association between two groups were assessed by Chi-square test (χ2), repeated measures and paired t-test. The statistical significance was considered when p-value<0.05. Results: Out of 100 patients, 52 patients were male and 48 were female, while the age range was 19-58 years. At 2 months, 43 (86%) patients recovered in the combination group and 41 (82%) in the steroid alone group (p-value=0.0038). At 6 months, 48 (96%) patients recovered in the combination group and 42 (84%) in the steroid alone group (p-value=0.178). The overall recovery rate was higher in the combination group (96%) compared to steroid alone group (84%). Conclusion: The combination of acyclovir with steroids in the treatment of Bell’s palsy has better recovery compared to steroid alone therapy.
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spelling doaj.art-32c86aa5cdf84da69035d5466ad5fc392023-01-31T11:10:43ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-01-01171MC01MC0410.7860/JCDR/2023/56306.17201Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, IndiaSR Kartrthika0K Priya1S Rajasekaran2D Balaji3Junior Resident, Deparment of Otorhinolaryngology, Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.Professor, Deparment of Otorhinolaryngology, Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.Professor and Head, Department of Otorhinolaryngology, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Assistant Professor, Department of Otorhinolaryngology, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Introdutcion: Idiopathic palsy of facial nerve is an acute disease which causes lower motor neuron palsy characterised by facial asymmetry leads to psychological effects and limits one’s social life. Steroids are very effective in the management of Bell’s palsy. The usage of antiviral is still in debate due to the idiopathic aetiology of Bell’s palsy. Aim: To evaluate the efficacy of acyclovir with steroid and steroid alone in the management of Bell’s palsy with respect to the recovery time. Materials and Methods: The randomised double-blinded study was conducted in the Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India, from September 2021 to February 2022 among 100 patients with idiopathic facial nerve palsy. Patients were divided into two groups, 50 patients in each. One group treated with acyclovir (400 mg oral five times daily) and methylprednisolone (1 mg/kg/day), and other group treated with steroid alone. Both the groups received physiotherapy in the Department of Physiotherapy and taught about home facial exercises. The patients were on regular follow-up for 6 months to monitor the time of the recovery. House-Brackmann grading system was used for initial assessment and monitor the recovery of the patient. The improvement of House-Brackmann grade to I or II was considered a satisfactory recovery. The association between two groups were assessed by Chi-square test (χ2), repeated measures and paired t-test. The statistical significance was considered when p-value<0.05. Results: Out of 100 patients, 52 patients were male and 48 were female, while the age range was 19-58 years. At 2 months, 43 (86%) patients recovered in the combination group and 41 (82%) in the steroid alone group (p-value=0.0038). At 6 months, 48 (96%) patients recovered in the combination group and 42 (84%) in the steroid alone group (p-value=0.178). The overall recovery rate was higher in the combination group (96%) compared to steroid alone group (84%). Conclusion: The combination of acyclovir with steroids in the treatment of Bell’s palsy has better recovery compared to steroid alone therapy.https://www.jcdr.net/articles/PDF/17201/56306_CE(AD)_F[SK]_PF1(SC_SH_KM)_PFA(SC_KM)_PN(KM).pdfantiviral drughouse-brackmann grading systemmethylprednisolone
spellingShingle SR Kartrthika
K Priya
S Rajasekaran
D Balaji
Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
Journal of Clinical and Diagnostic Research
antiviral drug
house-brackmann grading system
methylprednisolone
title Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
title_full Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
title_fullStr Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
title_full_unstemmed Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
title_short Acyclovir with Steroid and Steroid Alone in the Treatment of Idiopathic Facial Nerve Palsy: A Randomised Double-blinded Clinical Study from a Tertiary Care Centre, Chennai, India
title_sort acyclovir with steroid and steroid alone in the treatment of idiopathic facial nerve palsy a randomised double blinded clinical study from a tertiary care centre chennai india
topic antiviral drug
house-brackmann grading system
methylprednisolone
url https://www.jcdr.net/articles/PDF/17201/56306_CE(AD)_F[SK]_PF1(SC_SH_KM)_PFA(SC_KM)_PN(KM).pdf
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