Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine
<i>Background and Objectives</i>: Bell’s palsy, characterized by acute idiopathic facial nerve paralysis, exhibits variable recovery outcomes influenced by treatment timing, modality, and patient comorbidities. This study aimed to compare the effectiveness of corticosteroid-based treatme...
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MDPI AG
2025-07-01
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| author | Jaeyoon Chung Eunsung Park Jin Lee Cheol Lee |
| author_facet | Jaeyoon Chung Eunsung Park Jin Lee Cheol Lee |
| author_sort | Jaeyoon Chung |
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| description | <i>Background and Objectives</i>: Bell’s palsy, characterized by acute idiopathic facial nerve paralysis, exhibits variable recovery outcomes influenced by treatment timing, modality, and patient comorbidities. This study aimed to compare the effectiveness of corticosteroid-based treatment (Ear, Nose, and Throat [ENT]), nerve blocks/physical therapy (Pain Medicine), and acupuncture/herbal medicine (Traditional Korean Medicine [KM]) and identify predictors of recovery and recurrence. This retrospective cohort study leverages South Korea’s pluralistic healthcare system, where patients choose specialties, to provide novel insights into departmental treatment outcomes. <i>Materials and Methods</i>: We analyzed 600 patients treated within 72 h of Bell’s palsy onset (2010–2024) at Wonkwang University Hospital, South Korea, using propensity score matching (PSM) (1:1:1) for age, sex, comorbidities, and initial House–Brackmann (HB) grade. The primary outcome was complete recovery (HB grade I) at 6 months; secondary outcomes included recovery time, recurrence, complications, and patient satisfaction. Multivariate logistic regression identified predictors. <i>Results</i>: The ENT group achieved the highest complete recovery rate (87.5%, phi = 0.18) versus Pain Medicine (74.0%) and KM (69.5%) (<i>p</i> < 0.001), with the shortest recovery time (4 weeks, Cohen’s d = 0.65 vs. KM). Synkinesis was lowest in the ENT group (6.0%). ENT treatment (OR: 1.75; 95% CI: 1.29–2.37) and early corticosteroid application (OR: 1.95; 95% CI: 1.42–2.68) predicted recovery. Hypertension (OR: 4.40), hyperlipidemia (OR: 8.20), and diabetes (OR: 1.40) increased recurrence risk. Subgroup analyses showed that ENT treatment was most effective for severe cases (HB grade IV: 90% recovery vs. 65% in KM, <i>p</i> < 0.01). <i>Conclusions</i>: Corticosteroid-based treatment (ENT) yielded superior recovery outcomes. Comorbidity management is critical for recurrence prevention. Early ENT referral and integrated care models are recommended to optimize outcomes in diverse healthcare settings. |
| format | Article |
| id | doaj-art-488ae75bc87c48058d4e38d21475de82 |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-488ae75bc87c48058d4e38d21475de822025-08-20T02:47:17ZengMDPI AGMedicina1010-660X1648-91442025-07-01617123910.3390/medicina61071239Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean MedicineJaeyoon Chung0Eunsung Park1Jin Lee2Cheol Lee3Department of Anesthesiology, Wonkwang University Sanbon Hospital, Gunpo 15865, Republic of KoreaDepartment of Neurosurgery, School of Medicine Hospital, Wonkwang University, 895 Muwang-ro, Iksan-si 54538, Republic of KoreaDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine Hospital, Wonkwang University, Iksan-si 54538, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, School of Medicine Hospital, Wonkwang University, 895 Muwang-ro, Iksan-si 54538, Republic of Korea<i>Background and Objectives</i>: Bell’s palsy, characterized by acute idiopathic facial nerve paralysis, exhibits variable recovery outcomes influenced by treatment timing, modality, and patient comorbidities. This study aimed to compare the effectiveness of corticosteroid-based treatment (Ear, Nose, and Throat [ENT]), nerve blocks/physical therapy (Pain Medicine), and acupuncture/herbal medicine (Traditional Korean Medicine [KM]) and identify predictors of recovery and recurrence. This retrospective cohort study leverages South Korea’s pluralistic healthcare system, where patients choose specialties, to provide novel insights into departmental treatment outcomes. <i>Materials and Methods</i>: We analyzed 600 patients treated within 72 h of Bell’s palsy onset (2010–2024) at Wonkwang University Hospital, South Korea, using propensity score matching (PSM) (1:1:1) for age, sex, comorbidities, and initial House–Brackmann (HB) grade. The primary outcome was complete recovery (HB grade I) at 6 months; secondary outcomes included recovery time, recurrence, complications, and patient satisfaction. Multivariate logistic regression identified predictors. <i>Results</i>: The ENT group achieved the highest complete recovery rate (87.5%, phi = 0.18) versus Pain Medicine (74.0%) and KM (69.5%) (<i>p</i> < 0.001), with the shortest recovery time (4 weeks, Cohen’s d = 0.65 vs. KM). Synkinesis was lowest in the ENT group (6.0%). ENT treatment (OR: 1.75; 95% CI: 1.29–2.37) and early corticosteroid application (OR: 1.95; 95% CI: 1.42–2.68) predicted recovery. Hypertension (OR: 4.40), hyperlipidemia (OR: 8.20), and diabetes (OR: 1.40) increased recurrence risk. Subgroup analyses showed that ENT treatment was most effective for severe cases (HB grade IV: 90% recovery vs. 65% in KM, <i>p</i> < 0.01). <i>Conclusions</i>: Corticosteroid-based treatment (ENT) yielded superior recovery outcomes. Comorbidity management is critical for recurrence prevention. Early ENT referral and integrated care models are recommended to optimize outcomes in diverse healthcare settings.https://www.mdpi.com/1648-9144/61/7/1239Bell’s palsytreatment outcomerecurrence risk factors |
| spellingShingle | Jaeyoon Chung Eunsung Park Jin Lee Cheol Lee Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine Medicina Bell’s palsy treatment outcome recurrence risk factors |
| title | Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine |
| title_full | Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine |
| title_fullStr | Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine |
| title_full_unstemmed | Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine |
| title_short | Recovery and Recurrence in Bell’s Palsy: A Propensity Score-Matched Comparative Study Across ENT, Pain Medicine, and Traditional Korean Medicine |
| title_sort | recovery and recurrence in bell s palsy a propensity score matched comparative study across ent pain medicine and traditional korean medicine |
| topic | Bell’s palsy treatment outcome recurrence risk factors |
| url | https://www.mdpi.com/1648-9144/61/7/1239 |
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