title: Value of electroneurography as a prognostic indicator for recovery in acute severe inflammatory facial paralysis: a prospective study of Bell's palsy and Ramsay Hunt syndrome.
abstract: OBJECTIVE
  To evaluate the prognostic and predictive value of electroneuronography (ENoG) in acute severe inflammatory facial paralysis, including Bell's palsy and Ramsay Hunt syndrome (RHS).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Patients with acute severe facial paralysis of House-Brackmann (H-B) grade IV or worse and diagnosed with Bell's palsy or RHS were enrolled from August 2007 to July 2011. After treatment with oral corticosteroid, antiviral agent, and protective eye care, patients were followed up until recovery or 12 months from onset.
  
  
  RESULTS
  Sixty-six patients with Bell's palsy and 22 with RHS were included. Multiple logistic regression analysis showed significant effect of ENoG value on recovery in both Bell's palsy and RHS. Values of ENoG were significantly worse in RHS than Bell's palsy. Chance of early recovery within 6 weeks after correction of ENoG effect was still significantly worse in RHS. Logistic regression analysis showed 90% chance of recovery within 6 months, expected with ENoG values of 69.2% degeneration (Bell's palsy) and 59.3% (RHS). The receiver operating characteristics (ROC) curves showed ENoG values of 82.5% (Bell's palsy) and 78.0% (RHS) as a critical cutoff value of nonrecovery until 1 year, with the best sensitivity and specificity.
  
  
  CONCLUSIONS
  A higher chance of recovery was expected with better ENoG in Bell's palsy and RHS. Based on our data, nonrecovery is predicted in patients with ENoG value greater than 82.5% in Bell's palsy, and 78% in RHS.
  
  
  METHODS
  4.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; and the.
authors.forename: Hayoung
authors.initials: H
authors.lastname: Byun
authors.forename: Yang-Sun
authors.initials: YS
authors.lastname: Cho
authors.forename: Jeon Yeob
authors.initials: JY
authors.lastname: Jang
authors.forename: Kyu Whan
authors.initials: KW
authors.lastname: Chung
authors.forename: Soojin
authors.initials: S
authors.lastname: Hwang
authors.forename: Won-Ho
authors.initials: WH
authors.lastname: Chung
authors.forename: Sung Hwa
authors.initials: SH
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020330:Bell Palsy / Q000175:diagnosis*; D005260:Female; D016697:Herpes Zoster Oticus / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Acute facial paralysis; Bell's palsy; Kaplan-Meier survival analysis; Ramsay Hunt Syndrome; electroneurography; logistic regression; receiver operating characteristics