Mediterr J Otol 2006:2(2):78-82

Does diabetes mellitus affect the prognosis of idiopathic peripheral facial paralysis?

Güzin Akkuzu, O. Nuri Özgirgin,  Babür Akkuzu, Levent Özlüoğlu ozgirgin@polittzersociety.org

OBJECTIVE: Although peripheral neuropathy is a major aspect of the disease, a relationship between the pathogenesis of facial nerve paralysis and diabetes mellitus has not been proved. Management of diabetes mellitus also may be complicated by the corticosteroids used to treat facial nerve paralysis. In our hospital, patients with concomitant diabetes and facial nerve paralysis are always hospitalized to keep their blood sugar values at safe levels.

MATERIALS AND METHODS: We retrospectively investigated the medical reports of patients with peripheral facial paralysis treated in a 9 years period to document the efficacy of medical treatment. Blood sugar levels were monitored regularly and regulated by insulin.

RESULTS: Total decompression of the facial nerve was performed in 4 patients. Among the surgical patients, 1 diabetes patient had House-Brackmann grade 3/6 paralysis outcome and the other 3 patients (1 with diabetes, 2 without diabetes) had grades 1/6 to 2/6. Patients who refused surgical treatment showed incomplete improvement. Electroneuronography values for the other patients, including the 3 patients with House-Brackmann grade 6/6, showed a less than 90% difference between the 2 sides. All patients but 1 in the control group and 2 in the diabetes group showed an improvement to House-Brackmann grade 1/6 or 2/6, 9 months after treatment.

CONCLUSIONS: The presence of diabetes mellitus is a not a poor prognostic indicator in idiopathic facial nerve paralysis if treated with corticosteroids. However, high House-Brackmann grade paralysis has been an unfavorable prognostic sign. These patients must be closely monitored, and insulin should be administered to keep the blood sugar levels in safe range.