The outcome analysis of traumatic facial nerve palsy treated with systemic steroid therapy

Purpose: Although facial nerve palsy is uncommon after a blunt craniofacial injury, it will result in functional and aesthetic disability if full recovery is not achieved. Currently, the management is still controversial and mainly through systemic steroid therapy or surgical decompression. However, current studies mainly focus on the surgical intervention, and only a few of these studies discuss the details of the steroid treatments. Thus, the purpose of this study is to analyze possible prognosis factors of systemic steroid in managing traumatic facial nerve palsy after a blunt craniofacial injury retrospectively. Methods: During the period from May 2005 to April 2015 at Chang Gung Memorial Hospital, a total of 26 patients who suffered from post-traumatic facial nerve palsy receiving steroid therapy were enrolled in the study. All the patient’s charts were reviewed, recorded, and analyzed including the general data, temporal bone fracture type, hospital courses, trauma-related data from emergency room records, and initial and final facial nerve palsy grading. The facial nerve palsy was graded using the House-Brackmann (HB) system; the final HB grade I was set as full recovery. Results: The outcome showed steroid therapy onset within 24 hours (odds ratio [OR] = 10.111; 95% confidence interval [CI] = 1.597 – 64.005; P = 0.014) and steroid therapeutic duration for longer than 14 days (OR = 11.571; 95% CI = 1.172 – 114.262; P = 0.036) possessed a significantly better recovery rate. Conclusion: This study recommends to apply steroids within 24 hours once post-traumatic facial palsy occurs and the therapy should persist longer than 14 days.