Comparison of clinical prognostic factors between adult and pediatric patients with Bell’s palsy: An eighteen-year single center retrospective study

Identifying the clinical prognosis factors of Bell's palsy in adults and children is important to provide an early and accurate treatment for a better outcome. The aim of this study was to compare the clinical prognostic factors of Bell's palsy in adults and children and to identify specific factors that can predict recovery. This retrospective cohort study involved 1433 patients diagnosed with Bell's palsy (1355 adults and 78 children) who attended the outpatient clinic of a university hospital from 2005 to 2022. Age-based clinical factors for a favorable outcome 6 months after the onset of facial palsy were identified. Demographic and clinical data, such as sex, initial House-Brackmann grade, underlying conditions (e.g., diabetes mellitus, controlled hypertension), treatment methods, and electrophysiological test results, were collected. We evaluated clinical factors differing between adults and children and assessed the impact on recovery in Bell's palsy. The interactions between subgroups of adults and children and each variable were evaluated. No differences in prognostic factors between pediatric and adult patients based on an age cutoff of 19 years were found. Subgroup interactions could not be compared in children, because none of these patients had any underlying diseases. After adjusting for covariates, the odds ratios (ORs) of favorable recovery were higher in children than in adults with uncontrolled hypertension (OR; 2.67; 95% confidence interval [CI], 1.19-6.13) and diabetes mellitus (OR; 1.62; 95% CI, 1.08-2.42). Prognostic factors did not differ between pediatric and adult patients with Bell's palsy. However, the presence of comorbidities such as diabetes mellitus and hypertension may be important factors for the prognosis of adult patients with Bell's palsy.