Bell’s Palsy: Are Anti-virals Required?

Objectives: This study aimed to analyse the demographic profile, associated factors, treatment approaches, and outcomes of patients with Bell’s palsy (BP), and to compare the therapeutic efficacy of steroid monotherapy against combined steroid-antiviral therapy. Methods: Following approval from the institutional ethics committee, this retrospective analysis was carried out in the Department of Otolaryngology between January 2021 and January 2024. Data from 120 patients diagnosed with BP were reviewed. Group 1 ( n = 69) received corticosteroids alone, whereas Group 2 ( n = 51) received a combination of systemic corticosteroids and antiviral medication. Each group was further subdivided based on the time of treatment initiation—within 72 hours or after 72 hours of symptom onset. All patients were assessed before and after therapy using the House–Brackmann grading system. Results: No significant association was found between prognosis and either age or sex. Initiation of treatment within three days of onset was linked to better recovery. Patients treated with a steroid-antiviral combination demonstrated superior outcomes compared to those receiving steroid monotherapy. Conclusion: BP is an acute idiopathic lower motor neuron facial paralysis. Early initiation of combined corticosteroid and antiviral therapy, preferably within 72 hours of onset, is associated with improved recovery outcomes.