Lack of Evidence to Support the Beneficial Role of Intratympanic Dexamethasone Injection in Acute Peripheral Facial Palsy

Objectives:Adjunctive intratympanic dexamethasone injection (IT-DEX) has been used for the treatment of acute peripheral facial palsy (APFP). However, there are controversies regarding the validity of this treatment. In this study, we aimed to verify the feasibility of IT-DEX treatment for APFP.Study Design:Retrospective cohort study.Setting:Local university hospital.Patients and Methods:Data of patients treated for APFP between 2015 and 2018, and whose follow-up records for more than 3 months were available, were collected and analyzed based on whether adjuvant IT-DEX was administered.Main Outcome Measures:House-Brackmann grading at the initial visit, and at 2, 6, and 10 to 16 weeks after discharge. Patients with House-Brackmann I at any time point were regarded as having complete recovery (CR).Results:A total of 108 patients [57 men, 51 women; mean age, 48±15.67 yr (range: 18-85 yr)] were enrolled in the study. Adjunctive IT-DEX was administered to 41.7% (n=45) of patients during hospitalization. CR was observed in 71.7% of IT-DEX-treated patients; however, it was not significantly different from the conventional treatment group (79.4%) (p>0.05). Multiple regression analysis revealed that better facial grade at week 2 [EXP(B)=7.407, 95% CI=1.828-30.303, p=0.005] was significantly associated with CR. However, the number of IT-DEX treatment sessions was not a significant prognostic factor for predicting CR.Conclusion:Additional beneficial treatment effect was not observed with adjuvant IT-DEX. Thus, the use of IT-DEX for APFP should be reconsidered until scientific evidence for the basis of its use is established.