Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell’s Palsy
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Objectives. Factors predictive of the severity of and recovery from Bell’s palsy remain unclear. This study evaluated the association between neutrophil to lymphocyte ratio (NLR) and the severity of and recovery from Bell’s palsy. Methods. This retrospective study included 51 patients who were hospitalized with Bell’s palsy from 2015 to 2017. Degree of paralysis was assessed by House-Brackmann (H-B) grade. Patients with H-B grades 2–4 were classified as having mild to moderate palsy and patients with H-B grade 5 or 6 were classified as having severe palsy. Patients were evaluated for obesity, hypertension and diabetes mellitus, and blood tests were performed to determine NLR and platelet to lymphocyte ratio. Patients were treated with steroids and antiviral agents. H-B grade was assessed 1 week, 1 month, and 3 months after treatment. Results. NLR was significantly higher in patients with severe than with mild to moderate palsy (P=0.048). Recovery time was significantly longer in patients with high NLR than low NLR (P=0.045). Conclusion. Higher NLR in patients with Bell’s palsy was associated with longer recovery time. NLR may be prognostic of recovery time in patients with Bell’s palsy.
Abstract
Objectives. Factors predictive of the severity of and recovery from Bell’s palsy remain unclear. This study evaluated the association between neutrophil to lymphocyte ratio (NLR) and the severity of and recovery from Bell’s palsy. Methods. This retrospective study included 51 patients who were hospitalized with Bell’s palsy from 2015 to 2017. Degree of paralysis was assessed by House-Brackmann (H-B) grade. Patients with H-B grades 2–4 were classified as having mild to moderate palsy and patients with H-B grade 5 or 6 were classified as having severe palsy. Patients were evaluated for obesity, hypertension and diabetes mellitus, and blood tests were performed to determine NLR and platelet to lymphocyte ratio. Patients were treated with steroids and antiviral agents. H-B grade was assessed 1 week, 1 month, and 3 months after treatment. Results. NLR was significantly higher in patients with severe than with mild to moderate palsy (P=0.048). Recovery time was significantly longer in patients with high NLR than low NLR (P=0.045). Conclusion. Higher NLR in patients with Bell’s palsy was associated with longer recovery time. NLR may be prognostic of recovery time in patients with Bell’s palsy.
참고문헌 (28)
- De Diego JI, "Seasonal patterns of idiopathic facial paralysis : a 16-year study", Otolaryngol Head Neck Surg, 120(2), pp.269~271 (1999)
- Adour KK, "Herpes simplex virus in idiopathic facial paralysis(Bell palsy)", JAMA, 233(6), pp.527~530 (1975)
- Murakami S, "Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle", Ann Intern Med, 124(1 Pt 1), pp.27~30 (1996)
- Atan D, "New predictive parameters of bell’s palsy : neutrophil to lymphocyte ratio and platelet to lymphocyte ratio", Balkan Med J, 32(2), pp.167~170 (2015)
- Sahin C, "Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume and red cell distribution width measures in bells palsy", Open Access Maced J Med Sci, 5(1), pp.14~18 (2017)
- Ozler GS, "Neutrophil-lymphocyte ratio : a new predictive and prognostic factor in patients with Bell palsy", J Craniofac Surg, 25(3), pp.944~945 (2014)
- Xu N, "Predictive value of neutrophil to lymphocyte ratio in long-term outcomes of left main and", or three-vessel disease in patients with acute myocardial infarction, 2018, pp.91(S1), 551~557
- Song JY, "Combined pretreatment serum CA19-9 and neutrophil-to-lymphocyte ratio as a potential prognostic factor in metastatic pancreatic cancer patients", Medicine (Baltimore), 97(4), pp.e9707~ (2018)
- Huang QT, "Prognostic significance of neutrophil-to-lymphocyte ratio in ovarian cancer : a systematic review and meta-analysis of observational studies", Cell Physiol Biochem, 41(6), pp.2411~2418 (2017)
- Mascarella MA, "Neutrophil-tolymphocyte ratio in head and neck cancer prognosis : a systematic review and meta-analysis", Head Neck, 40(5), pp.1091~1100 (2018)
- Miehlke A, "Surgery of the facial nerve" (1973), W.B. Saunders
- Mannarelli G, "Electrophysiological measures in facial paresis and paralysis", Oper Tech Otolayngol Head Neck Surg, 23(4), pp.236~247 (2012)
- Baugh RF, "Clinical practice guideline: Bell’s palsy", Otolaryngol Head Neck Surg, 149(3 Suppl), pp.S1~S27 (2013)
- Forget P, "What is the normal value of the neutrophil-to-lymphocyte ratio?", BMC Res Notes, 10(1), pp.12~ (2017)
- World Health Organization, "The Asia-Pacific perspective: redefining obesity and its treatment" (2000), Health Communications Australia
- Choi SA, "Association between recovery from Bell’s palsy and body mass index", Clin Otolaryngol, 42(3), pp.687~692 (2017)
- Volk GF, "Prognostication of recovery time after acute peripheral facial palsy : a prospective cohort study", BMJ Open, 3(6), pp.e003007~ (2013)
- Hilger JA, "The nature of Bell’s palsy", Laryngoscope, 59(3), pp.228~235 (1949)
- Abramsky O, "Cellular immune response to peripheral nerve basic protein in idiopathic facial paralysis(Bell’s palsy)", J Neurol Sci, 26(1), pp.13~20 (1975)
- Townsend JJ, "Peripheral nervous system demyelination with herpes simplex virus", J Neuropathol Exp Neurol, 45(4), pp.419~425 (1986)
- Fisch U, "Total intratemporal exposure of the facial nerve : pathologic findings in Bell’s palsy", Arch Otolaryngol, 95(4), pp.335~341 (1972)
- Kilickaya MM, "The importance of the neutrophil-lymphocyte ratio in patients with idiopathic peripheral facial palsy", Int J Otolaryngol, 2015, pp.981950~ (2015)
- Bucak A, "Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy", Laryngoscope, 124(7), pp.1678~1681 (2014)
- Nadeau S, "Functional recovery after peripheral nerve injury is dependent on the pro-inflammatory cytokines IL-1β and TNF : implications for neuropathic pain", J Neurosci, 31(35), pp.12533~12542 (2011)
- Benowitz LI, "Inflammation and axon regeneration", Curr Opin Neurol, 24(6), pp.577~583 (2011)
- Monteiro R, "Chronic inflammation in obesity and the metabolic syndrome", Mediators Inflamm, 2010, pp.289645~ (2010)
- Kum RO, "Elevated neutrophil-to-lymphocyte ratio in Bell’s palsy and its correlation with facial nerve enhancement on MRI", Otolaryngol Head Neck Surg, 152(1), pp.130~135 (2015)
- Sevik Elicora S, "Does type 2 diabetes mellitus affect the healing of Bell’s palsy in adults?", Can J Diabetes, 42(4), pp.433~436 (2018)