Estudio pronóstico de las parálisis faciales periféricas en el Complejo Asistencial Universitario de Salamanca

Abstract

Introduction and objective: Peripheral Facial Paralysis (PFP) has an average incidence of 20 cases per 100,000 population per year. The facial nerve in its tympanic path releases a motor branch for the stapedius muscle: The stapedial nerve. The aim of this study is to investigate the usefulness and prognostic significance of tests performed in the PFP diagnostic protocol, such as the stapedial reflex, taste test or viral serology.

Method: A retrospective cohort study of 161 patients with a diagnosis of PFP from the University Healthcare Complex of Salamanca is carried out. The sample is divided according to the presence or absence of the stapedial reflex at the diagnosis of PFP. Follow-up is included using the score according to the Stennert criteria in successive check-ups, initially before the sixth day, between 10-12 days, and monthly thereafter. The prognosis of this pathology linked to three factors is assessed: The presence or absence of the stapes muscle reflex, taste alteration and positivity in serology.

Results: The sample is 161 patients with PFP. The stapedial reflex at diagnosis was present in 101 patients (62.7%) and absent in 60 patients (37.3%). The results during follow-up according to Stennert’s criteria show that 95% of patients with present stapedial reflex are cured by the third month, compared to 47.37% of patients with absence of said reflex (p=0.001). Of the patients with dysgeusia, 75% reach it, compared to 76.09% of the patients without dysgeusia (p=0.893). And of the patients with positive serology, it is reached by 79.17% compared to 76.41% of those with negative serology (p=0.773).

Discussion: The stapedial reflex has been mentioned as a prognostic factor in PFP only in old publications. Patients with the presence of the reflex show a lower score on the Stennert criteria at the beginning than those with the absent reflex, having moderate and severe paralytic involvement, respectively. The patients in the first group recovered more quickly and without sequelae, a difference referred to in previous studies.

Conclusions: The presence or absence of the stapedial reflex at diagnosis is an important prognostic factor in Peripheral Facial Paralysis. Dysgeusia and serology do not provide prognostic assessment in this study.