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Adding Antiviral Agent to Steroids for Bell's Palsy Not Associated With Improved Recovery CHICAGO -- June 15, 2009 -- Adding an antiviral agent to corticosteroids for treatment of Bell’s palsy is not associated with improved recovery of facial movement function, according to a meta-analysis of previously published studies appearing in the June issue of Archives of Otolaryngology-Head & Neck Surgery. Current treatment choices for Bell’s palsy include corticosteroids, antiviral therapy or a combination of the two. John K. Goudakos, MD, and Konstantinos D. Markou, MD, University of Thessaloniki, Thessaloniki, Greece, identified randomised controlled trials comparing corticosteroids to combination therapy in patients with this condition published between 1996 and 2007. A total of 5 eligible studies involving 738 patients were identified, 4 of which were included in the meta-analysis (n = 709; 358 taking corticosteroids and 351 taking combination therapy). “The complete recovery rate of facial motor function at 3 months after the initiation of therapy was not significantly different between the corticosteroids group and the combined therapy group,” the authors wrote. Adverse effects also were not significantly different between the 2 treatment groups. “Treatment decisions regarding patients with Bell’s palsy are doubtful and remain a common problem in medical practice. Corticosteroids have been established as the therapy of choice, despite the fact that the available evidence from randomised controlled trials does not exhibit a clear benefit. However, the largest available randomised controlled trial published recently suggested a benefit from the use of corticosteroids in patients with idiopathic acute facial paralysis,” the authors concluded. “Additional well-designed randomised controlled trials are needed to assess the potential value of antiviral addition to the recovery of facial palsy with more confidence. However, based on the currently available evidence, the addition of an antiviral agent to corticosteroids for the treatment of patients with Bell’s palsy is not justified.” SOURCE: Archives of Otolaryngology-Head & Neck Surgery E-mail this page to a friend or colleague! To print, use this version