Clin Exp Otorhinolaryngol.  2019 Aug;12(3):261-266. 10.21053/ceo.2018.01018.

Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell's Palsy

• Kim HS
• Jung J
• Dong SH
• Kim SH
• Jung SY
• Yeo SG

• KMID: 2455366
• DOI: http://doi.org/10.21053/ceo.2018.01018

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.

Keyword

Neutrophils; Lymphocytes; Bell Palsy; Facial Paralysis

MeSH Terms

Antiviral Agents
Bell Palsy*
Blood Platelets
Diabetes Mellitus
Facial Paralysis
Hematologic Tests
Humans
Hypertension
Lymphocytes*
Neutrophils*
Obesity
Paralysis
Retrospective Studies
Steroids
Antiviral Agents
Steroids

Figure

• 

  Fig. 1. Relationships between hypertension (HTN), diabetes mellitus (DM), body mass index (BMI), and neutrophil to lymphocyte ratio (NLR) and recovery time in patients with Bell’s palsy. Normal weight, BMI <25 kg/m2 ; obesity, BMI ≥25 kg/m2 and normal NLR, ≤3.53; high NLR, >3.53. *P<0.05.

• 

  Fig. 2. Relationships between hypertension (HTN), diabetes mellitus (DM), body mass index (BMI), and neutrophil to lymphocyte ratio (NLR) and initial severity in patients with Bell’s palsy. H-B grade, House-Brackmann grade; normal weight, BMI <25 kg/m2 ; obesity, BMI ≥25 kg/m2 ; normal NLR, ≤3.53; high NLR, >3.53. *P<0.05.

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