Endocrine Abstracts

Objective: Our study aims to review the therapeutic management guideline of diabetic patients who presented with Bell’s palsy.

Materials and Methods: A retrospective study which consisted of 35 diabetic patients with idiopathic peripheral facial paralysis (PFP) over a period of 3 years (from January 2020 to December 2022). All patients underwent a complete ENT examination, a neurological examination, and a minimal assessment including a complete blood count, blood glucose measurement, and an audiometry (tonal audiometry + impedance audiometry).

Results: Our series identified 10 female and 25 male, with an average age of 47 years (26–65 years). Others than diabetes, risk factors for PFP were found within 29 patients, involving hypertension, hematological disorders, and pregnancy. Twenty-four cases were classified as type 2 diabetes, 22 of them were treated with Oral antidiabetic medications. All patients presented with an unilateral facial asymmetry, with an average delay of consultation of 3 days. In the initial physical examination, 20 patients presented with mild-to-moderate facial palsies (grades I-III), while moderate-to-severe palsies (grades IV–VI) were observed in fifteen of the patients. Twelve patients underwent a cerebral computed tomography, completed in one case of a magnetic resonance imaging, showing normal results. Stapedial reflex was absent in 19 cases. Eleven patients were treated on an outpatient basis while twenty-four patients required hospitalization, including 4 children. Corticosteroid therapy based on prednisolone or methylprednisolone was initiated in all patients with an average duration of 7 days. Antiviral treatment, always in combination with corticosteroid therapy, was prescribed for 21 patients with an average consultation delay of 3 days. All patients received vasodilators and vitamin therapy. Facial rehabilitation was initiated in all cases with an average delay of 7 days (3–10 days). After 1 year of follow-up, 19 patients recovered normal facial tone

Conclusion: Bell’s palsy is the most common form of facial paralysis therefore it remains a diagnosis of exclusion. The therapeutic management in diabetics relies on an early combination of corticosteroids and antivirals. The prognosis is often favorable, with the potential for aesthetic and functional sequelae.