TY  - JOUR
T1  - EVALUATION OF RECOVERY BY STAPES REFLEX IN PATIENTS WITH PERIPHERAL FACIAL PARALYSIS
TT  - Periferik Fasiyal Paralizisi Olan Hastalarda Stapes Refleksiyle İyileşmenin Değerlendirilmesi
AU  - Cömert, Ela
AU  - Tekin, Yasin
PY  - 2024
DA  - April
DO  - 10.24938/kutfd.1362563
JF  - The Journal of Kırıkkale University Faculty of Medicine
JO  - Kırıkkale Uni Med J
PB  - Kırıkkale Üniversitesi
WT  - DergiPark
SN  - 2148-9645
SP  - 13
EP  - 18
VL  - 26
IS  - 1
LA  - en
AB  - Objective: The aim of this study was to investigate the acoustic reflex in different frequencies at the time of diagnosis, during the treatment and follow-up of patients with idiopathic peripheral facial nerve palsy and compare these results with House-Brackmann clinical scoring to determine the prognostic value of acoustic reflex in these patients.Material and Methods: Thirty-three adult patients with idiopathic peripheral facial palsy (aged 18-77 years, 16 male, 17 female) were included in the study. All the patients were clinically graded with House-Brackmann clinical scoring and acoustic reflex test was performed at the time of diagnosis, 1st, 2nd, 3rd, 4th weeks, 2nd and 3rd month. Ipsilateral acoustic reflex thresholds were measured from both ears with impedance audiometry using a 226 Hz probe tone.Results: Significant relation was observed between the presence of sequel and initial grade and absence of acoustic reflex at 0.5, 1, 2 kHz at time of diagnosis. In addition, after the 1st week, a significant relation was also detected at 4 kHz frequency during all the follow-up period. The risk of sequelae would increase more than 3 times as the initial grade value increased.Conclusion: The present study revealed the relation between the sequel and initial high grade, the absence of acoustic reflex at 0.5, 1, 2 kHz at time of diagnosis in addition with high age. Statistics does not support the same relation at 4 kHz frequency at time of diagnosis. However, statistic reveals that only the initial grade can best predict the risk of sequel, in addition, the risk of sequel increases more than 3 times as the initial grade value increase.
KW  - Facial paralysis
KW  - acoustic impedance test
KW  - prognosis
N2  - Amaç: Bu çalışmanın amacı idiyopatik periferik fasiyal paralizi olan hastaların tanı anında, tedavi ve takibinde farklı sıklıklardaki akustik refleksleri araştırmak ve bu sonuçları House-Brackmann klinik skorlaması ile karşılaştırarak prognostik değeri belirlemektir.Gereç ve Yöntemler: Çalışmaya idiyopatik periferik fasiyal paralizi olan 33 yetişkin hasta (18-77 yaş arası, 16 erkek, 17 kadın) dahil edildi. Tüm hastalar House-Brackmann klinik skorlaması ile klinik olarak evrelendi ve tanı anında, 1., 2., 3.,4. hafta, 2. ve 3. ayda akustik refleks testi yapıldı. İpsilateral akustik refleks eşikleri, 226 Hz'lik bir prob tonu kullanılarak empedans odyometrisi ile her iki kulaktan ölçüldü.Bulgular: Sekel varlığı ve başlangıç evresi ile tanı anındaki 0.5, 1, 2 kHz'de akustik refleksin olmaması arasında anlamlı ilişki gözlendi. Ayrıca 1. haftadan sonra tüm takip süresi boyunca 4 kHz frekansında da anlamlı bir ilişki tespit edildi. Başlangıç evresi arttıkça sekel riskinin 3 kattan fazla artacağı görüldü.Sonuç: Bu çalışma, ilerleyen yaş ile birlikte tanı anında 0.5, 1, 2 kHz'de akustik refleksin olmaması ve başlangıçtaki yüksek evre ile sekel arasındaki ilişkiyi ortaya koymuştur. Ancak istatistiksel inceleme sekel riskini yalnızca başlangıç evresinin en iyi şekilde tahmin edebileceğini, ayrıca başlangıç evresi arttıkça sekel riskinin 3 kattan fazla artacağını ortaya koymuştur.
CR  - Brown JS. Bell's palsy, a 5 year review of 174 consecutive cases an attempted double blind study. Laryngoscope. 1982;92(12):1369-1373.
CR  - Kopala W, Kukwa A. Evaluation of the acoustic (stapedius) reflex test in children and adolescents with peripheral facial nerve palsy. Int J of Pediatr Otorhinolaryngology. 2016;89:102-106.
CR  - Ide M, Morimitsu T, Ushisako Y, Makino K, Fukiyama M, Hayashi A. The significance of stapedial reflex test in facial nerve paralysis. Acta Otolaryngol Suppl. 1988;446:57-63.
CR  - Geißler K, Urban E, Volk GF, Klingner CM, Witte OW, Guntinas-Lichius O. Non-idiopathic peripheral facial palsy: Prognostic factors for outcome. Eur Arch Otorhinolaryngol. 2021;278(9):3227-3235.
CR  - Swan IR, Donnan PT, Morrison JM et al. Early treatment with prednisolone or acyclovir in Bell’s palsy. N Engl J Med. 2007;357(16):1598-1607.
CR  - Engström M, Berg T, Stjernquist-Desatnik A et al. Prednisolone and valaciclovir in Bell’s palsy: A randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2008;7(11):993-1000.
CR  - Ralli G, Magliulo G, Gagliardi M. Bell's palsy and stapedial reflex. Clin Otolaryngol Allied Sci. 1986;11(4):261-265.
CR  - Volk GF, Klingner C, Finkensieper M, Witte OW, Guntinas-Lichius O. Prognostication of recovery time after acute peripheral facial palsy: A prospective cohort study. BMJ Open. 2013;3(6):e003007.
CR  - Rosen G, Sellars SL. The stapedius reflex in idiopathic facial palsy. J Laryngol Otol. 1980;94(9):1017-1020.
UR  - https://doi.org/10.24938/kutfd.1362563
L1  - https://dergipark.org.tr/tr/download/article-file/3417327
ER  -