Efficacy and Safety of Corticosteroid in Adult Facial Nerve Palsy Through House-Brackmann Scale Measurement: A Meta-Analysis of Randomized Controlled Trials
Joshua Limantoro1, Ayu Merta Sari1, Made K.Cahyani1, Khaled Moghib2
1Faculty of Medicine, Udayana University, Bali, Indonesia, 2Faculty of medicine Kasralainy, Cairo university
Objective:
to provide information on the efficacy and safety of corticosteroid use in treating adult FNP patients.
Background:
The management of facial nerve palsy (FNP) remains a subject of debate. Various studies have shown that corticosteroids are a promising therapeutic agent; however, some research results are inconsistent. We conducted a meta-analysis of randomized controlled trials (RCTs) to provide information on the efficacy and safety of corticosteroid use in treating adult FNP patients.
Design/Methods:
An online search through electronic journals, including Cochrane Library, PubMed, Science Direct, PlosOne, and ProQuest was conducted to compare corticosteroid and placebo for FNP patients. The primary outcome was the efficacy of corticosteroids in achieving FNP recovery at the 3rd, 6th, and 9th months post-treatment. The House-Brackmann Scale measurement of 1 was used as an indication for recovery. The secondary outcome includes the adverse effects comparison. The final analysis included 5 RCTs with 1064 adult patients; and 532 patients in both the corticosteroid and placebo group.
Results:
This meta-analysis concludes significant difference favouring the corticosteroid group in achieving recovery at 3 (RR 1.20; 95% CI 0.89 to 1.60), 6 (RR 1.16; 95% CI 1.02 to 1.32), and 9 months (RR 1.11; 95% CI 1.04 to 1.19). Another sub-group analysis for FNP of idiopathic cause within 0-72 hours onset showed a significant difference favouring the corticosteroid group in achieving recovery at 3 months (RR 1.27; 95% CI 1.16 to 1.39). However, no significant differences were found in the amount of total adverse effects (RR 0.93; 95% CI 0.79 to 1.08).
Conclusions:
This study suggests that corticosteroid utilization for adult FNP patients results in a significantly better recovery rate with a similar safety profile compared to placebo therapy. Further studies are required to assess treatment duration, dose, and indications for clinical use.
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