Bell’s palsy

Minnerop, Martina; Herbst, Martin; Fimmers, Rolf; Matz, Bertfried; Klockgether, Thomas; Wüllner, Ullrich

doi:10.1007/s00415-008-0008-6

Cited by 47 publications

(9 citation statements)

References 23 publications

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“…A total of 574 patients who received steroids alone and 571 patients who received steroids and antivirals were included. Three studies used aciclovir as the antiviral,6 10 22 two studies used valaciclovir,12 14 and one study used famciclovir 9. Most of the included studies were of high quality (Jadad score ≥3) except for Minnerop et al,9 which was not blinded.…”

Section: Resultsmentioning

confidence: 99%

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The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis

Quant

Jeste

Muni

et al. 2009

BMJ

114

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Objective To determine whether steroids plus antivirals provide a better degree of facial muscle recovery in patients with Bell’s palsy than steroids alone.Design Meta-analysis.Data sources PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies published in all languages from 1984 to January 2009. Additional studies were identified from cited references.Selection criteria Randomised controlled trials that compared steroids with the combination of steroids and antivirals for the treatment of Bell’s palsy were included in this study. At least one month of follow-up and a primary end point of at least partial facial muscle recovery, as defined by a House-Brackmann grade of at least 2 (complete palsy is designated a grade of 6) or an equivalent score on an alternative recognised scoring system, were required.Review methods Two authors independently reviewed studies for methodological quality, treatment regimens, duration of symptoms before treatment, length of follow-up, and outcomes. Odds ratios with 95% confidence intervals were calculated and pooled using a random effects model.Results Six trials were included, a total of 1145 patients; 574 patients received steroids alone and 571 patients received steroids and antivirals. The pooled odds ratio for facial muscle recovery showed no benefit of steroids plus antivirals compared with steroids alone (odds ratio 1.50, 95% confidence interval 0.83 to 2.69; P=0.18). A one study removed analysis showed that the highest quality studies had the greatest effect on the lack of difference between study arms shown by the odds ratio. Subgroup analyses assessing causes of heterogeneity defined a priori (time from symptom onset to treatment, length of follow-up, and type of antiviral studied) showed no benefit of antivirals in addition to that provided by steroids.Conclusions Antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy. This study does not, therefore, support the routine use of antivirals in Bell’s palsy. Future studies should use improved herpes virus diagnostics and newer antivirals to assess whether combination therapy benefits patients with more severe facial paralysis at study entry.

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Section: Resultsmentioning

confidence: 99%

“…There was one inter-reviewer disagreement during data extraction, which was resolved by a third independent reviewer. The Sullivan et al,6 the Minnerop et al,9 and the Adour et al22 studies did not report the necessary data regarding the groups of interest; the corresponding authors were contacted and kindly provided the necessary information.…”

Section: Methodsmentioning

confidence: 99%

The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis

Quant

Jeste

Muni

et al. 2009

BMJ

114

View full text Add to dashboard Cite

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“…Conflicting results were reported in different studies on the benefit of combining anti viral therapy with corticosteroid to achieve better outcome. Minnerop et al reported that combination of famciclovir and prednisone was superior to prednisone alone in cases of severe Bell's palsy [188]. Combining antiviral therapy with prednisone increase the recovery rate slightly but not significantly compared to prednisone monotherapy [189].…”

Section: Bell's Palsymentioning

confidence: 99%

66 Years of Corticosteroids in Dentistry: And We Are Still at a Cross Road?

Ngeow¹,

Lim²,

Ahmad³

2018

Corticosteroids

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Most of the corticosteroids prescribed in dentistry are for topical applications or short-term usage, rarely for its systemic effects or for long-term consumption, as in the treatment of some medical conditions. Among the various specialties in dentistry, oral and maxillofacial surgery, oral medicine and endodontics are the more frequent users of corticosteroids. Corticosteroids are used in oral and maxillofacial procedures to reduce associated post-operative inflammation. The most researched outcome on the use of corticosteroids in oral and maxillofacial surgery revolves around their impact to reduce post-operative pain, swelling and trismus. Topical corticosteroids, on the other hand, are effective in treating various oral mucosal lesions including oral ulcerations and oral presentations of auto-immune diseases. Corticosteroids are also used as part of the treatment of temporomandibular joint disorders. Intracanal placement of corticosteroids is used in endodontic treatment. This chapter reviews the use of corticosteroids in the three specialties of dentistry as mentioned.

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“…In contrast, the meta-analysis by Quant et al. (2009) , including the study by Minnerop et al. (2008) but excluding those by Kawaguchi et al.…”

Section: Managementmentioning

confidence: 99%