Proposal of a New Weighted Prognostic Factor Scoring System (WPFSS) in Bell’s Palsy

Background and Objectives: To analyze various parameters that influence Bell’s palsy prognosis at an early disease stage. Material and Methods: In total, 384 patients at Dong-Eui Medical Center in Busan, Korea, were retrospectively assessed from January 2004 to December 2006. The following clinical aspects were analyzed: gender, age, hypertension, postauriclular pain, vertigo, number of days from onset of facial weakness to the commencing treatment, electroneurography (ENoG) results, initial facial palsy grading, and the degree of facial palsy after 3 months. Statistical analyses of the total sum score were performed for patients with different recoveries 3 months post-onset. To accomplish this, a weighted prognostic factor scoring system (WPFSS) that served as an integrated system to analyze multiple predictive factors of Bell’s palsy prognosis was created. Results: Results from the univariate analysis of recovery indicated that only age, ENoG response, and initial grading of facial palsy were directly correlated with recovery rate in patients with Bell’s palsy 3 months post-onset. Using the WPFSS, a distinct gap was observed, which allowed for the factors to be grouped into four distinct sections that were dependent on the recovery rate. Groups with scores below 11 and above 15 points were considered to have a satisfactory recovery rate of greater than 70% and less than 9.1%, respectively. Conclusions: The WPFSS may provide an objective criterion for prognostic assessment and implementation of risk-adapted treatment strategies in Bell’s palsy patients. (J Clinical Otolaryngol 2016;27:67–75)