Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T16:36:56.946Z Has data issue: false hasContentIssue false

Clinical analysis of acute peripheral facial palsy in older adults

Published online by Cambridge University Press:  07 January 2022

D Y Jeong
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
H Kim
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
S I Cho*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Chosun University College of Medicine, Gwangju, South Korea
*
Author for correspondence: Prof Sung Il Cho, Department of Otolaryngology – Head and Neck Surgery, Chosun University, 365 Pilmun-daero, Dong-gu, Gwangju 61453, South Korea E-mail: chosi@chosun.ac.kr Fax: +82 62 225 2702

Abstract

Objective

Acute facial palsy is a consequence of various diseases, with the number of patients increasing with advancing age. This study aimed to analyse the clinical characteristics of acute peripheral facial palsy in older adults.

Methods

A total of 30 patients with a mean age of 68.4 ± 9.1 years were included in the study. All patients received a standardised investigation and follow up. The hospital charts of the patients with acute facial palsy were reviewed retrospectively.

Results

The predominant causes of acute facial palsy in older adults were: Bell's palsy, Ramsay Hunt syndrome, trauma, otitis media and malignancy. At baseline, complete and incomplete facial palsies were seen in 26.7 per cent and 73.3 per cent of patients, respectively. The overall rates of good recovery, partial recovery and no recovery were 66.7 per cent, 10 per cent and 23.3 per cent, respectively. Increased age led to a significantly lower level of recovery in older adults.

Conclusion

Bell's palsy and Ramsay Hunt syndrome were the most common aetiologies of acute facial palsy in older adults, and such patients are likely to have incomplete recovery. Active early treatment is necessary for achieving good outcomes in older adults.

Type
Main Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Prof S I Cho takes responsibility for the integrity of the content of the paper

References

Lee, DH. Clinical efficacy of electroneurography in acute facial paralysis. J Audiol Otol 2016;20:812CrossRefGoogle ScholarPubMed
Chang, YS, Choi, JE, Kim, SW, Baek, SY, Cho, YS. Prevalence and associated factors of facial palsy and lifestyle characteristics: data from the Korean National Health and Nutrition Examination Survey 2010–2012. BMJ Open 2016;6:e012628CrossRefGoogle ScholarPubMed
Kondo, N, Yamamura, Y, Nonaka, M. Patients over 60 years of age have poor prognosis in facial nerve decompression surgery with preserved ossicular chain. J Int Adv Otol 2018;14:7784CrossRefGoogle ScholarPubMed
Cai, Z, Li, H, Wang, X, Niu, X, Ni, P, Zhang, W et al. Prognostic factors of Bell's palsy and Ramsay Hunt syndrome. Medicine (Baltimore) 2017;96:e5898CrossRefGoogle ScholarPubMed
Lee, HY, Byun, JY, Park, MS, Yeo, SG. Effect of aging on the prognosis of Bell's palsy. Otol Neurotol 2013;34:766–70CrossRefGoogle ScholarPubMed
Hyun, KR, Kang, S, Lee, S. Population aging and healthcare expenditure in Korea. Health Econ 2016;25:1239–51CrossRefGoogle ScholarPubMed
May, M, Klein, SR. Differential diagnosis of facial nerve palsy. Otolaryngol Clin North Am 1991;24:613–45CrossRefGoogle ScholarPubMed
Kim, SH, Jung, J, Jung, SY, Dong, SH, Byun, JY, Park, MS et al. Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell's palsy. Eur Arch Otorhinolaryngol 2019;276:1011–16CrossRefGoogle ScholarPubMed
Adour, KK. Otological complications of herpes zoster. Ann Neurol 1994;35(suppl):S62–4CrossRefGoogle ScholarPubMed
Tovi, F, Hadar, T, Sidi, J, Sarov, I, Sarov, B. Epidemiological aspects of idiopathic peripheral facial palsy. Eur J Epidemiol 1986;2:228–32CrossRefGoogle ScholarPubMed
De Diego, JI, Prim, MP, Madero, R, Gavilán, J. Seasonal patterns of idiopathic facial paralysis: a 16-year study. Otolaryngol Head Neck Surg 1999;120:269–71Google ScholarPubMed
Peitersen, E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002;549:430CrossRefGoogle Scholar
Peitersen, E. Natural history of Bell's palsy. Acta Otolaryngol Suppl 1992;492:122–4CrossRefGoogle ScholarPubMed
Ryu, EW, Lee, HY, Lee, SY, Park, MS, Yeo, SG. Clinical manifestations and prognosis of patients with Ramsay Hunt syndrome. Am J Otolaryngol 2012;33:313–18CrossRefGoogle ScholarPubMed
Devriese, PP, Schumacher, T, Scheide, A, de Jongh, RH, Houtkooper, JM. Incidence, prognosis and recovery of Bell's palsy. A survey of about 1000 patients (1974–1983). Clin Otolaryngol Allied Sci 1990;15:1527CrossRefGoogle Scholar
Yeo, SW, Lee, DH, Jun, BC, Chang, KH, Park, YS. Analysis of prognostic factors in Bell's palsy and Ramsay Hunt syndrome. Auris Nasus Larynx 2007;34:159–64CrossRefGoogle ScholarPubMed
Yanagihara, N, Hyodo, M. Association of diabetes mellitus and hypertension with Bell's palsy and Ramsay Hunt syndrome. Ann Otol Rhinol Laryngol Suppl 1988;137:57CrossRefGoogle ScholarPubMed
Jörg, R, Milani, GP, Simonetti, GD, Bianchetti, MG, Simonetti, BG. Peripheral facial nerve palsy in severe systemic hypertension: a systematic review. Am J Hypertens 2013;26:351–6CrossRefGoogle ScholarPubMed
Ducker, TB, Kempe, LG, Hayes, GJ. The metabolic background for peripheral nerve surgery. J Neurosurg 1969;30:270–80CrossRefGoogle ScholarPubMed
Boccia, G, Dardanello, D, Rosso, V, Pizzigalli, L, Rainoldi, A. The application of sEMG in aging: a mini review. Gerontology 2015;61:477–84CrossRefGoogle ScholarPubMed
Kiziltan, ME, Uluduz, D, Yaman, M, Uzun, N. Electrophysiological findings of acute peripheral facial palsy in diabetic and non-diabetic patients. Neurosci Lett 2007;418:222–6CrossRefGoogle ScholarPubMed
Shinnabe, A, Hara, M, Hasegawa, M, Matsuzawa, S, Kanazawa, H, Yoshida, N et al. Clinical characteristics and surgical benefits and problems of chronic otitis media and middle ear cholesteatoma in elderly patients older than 70 years. Otol Neurotol 2012;33:1213–17CrossRefGoogle ScholarPubMed
O TM. Medical management of acute facial paralysis. Otolaryngol Clin North Am 2018;51:1051–75CrossRefGoogle Scholar