Efficacy of Combination and Single Therapy in Bell's Palsy: A Systematic Review and Meta-Analysis

Background: Bell's palsy is an acute, asymmetrical paralysis of facial muscles resulting from peripheral facial nerve dysfunction without a discernible origin.Combination therapy, which leverages the benefits of both antivirals and steroids, may be an effective treatment for Bell's palsy.We aimed to evaluate the effectiveness of steroids antiviral treatments for facial paralysis.Methods: A systematic search was conducted using the Scopus, PubMed, and Web of Science databases.The search terms used were: (Bell's palsy OR facial palsy) AND (steroids OR corticosteroids) AND antiviral.All selected articles were published between 1990 and Jan 2023.Comprehensive Meta-Analysis (CMA) version 3 was used for statistical analysis and graph construction.Results: After a full-text evaluation, 14 studies were included.The comparison of patient outcomes between the two treatment groups indicated that combination therapy was more effective than single therapy.Famciclovir, valacyclovir, and acyclovir, respectively, showed the most significant synergistic effect with corticosteroids.According to Egger's test, no significant bias was found in the comparison of the two treatment groups. Conclusion:Combination therapy (corticosteroid and antiviral) is significantly more effective than single corticosteroid therapy.Among the antiviral agents, famciclovir, valacyclovir, and acyclovir demonstrated the highest efficacy in combination with corticosteroids.