Infusion therapy for acute idiopathic peripheral facial palsy. Results of 334 cases

Antiphlogistic-rheologic infusion therapy is a widespread and well-establis hed treatment modality for acute idiopathic facial paralysis (AIFP) in many German centers of otorhinolaryngology. However, there is still a lack of c onvincing data concerning this regimen's functional results and side effect s. The medical records of 344 patients who were treated for AIFP between 19 87 and 1997 were analyzed retrospectively. In 239 cases there was reliable information on functional outcome. Therapy consisted uniformly of intraveno us infusion with prednisolone (250 mg initially, then tapering over 18 days ) and simultaneous administration of dextran and pentoxifylline. From 239 p atients with non-recurrent palsy having received treatment within 12 days a fter onset, 92.1% recovered completely without sequelae. In case of incompl ete palsy (House-Brackmann grade II-V) normal facial function was restored in 97,7% of cases. Results were significantly better in the group in which therapy had been started within 3 days after onset of palsy. Adverse effect s occurred rarely and were transient and mild in most cases. High-dose pred nisolone in combination with low-molecular dextran and pentoxifylline for A IFP is a safe treatment modality leading to recovery rates superior to the most optimistic observations of the natural course of Bell's palsy. In the absence of a definitive controlled trial, the present study, although retro spective, is considered valid to show the effectiveness of our protocol. In the light of our data and of other publications, early treatment with cort icosteroids in sufficient dosage seems appropriate, while therapeutic nihil ism in AIFP does not seem justified.