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학술저널

소아청소년에서 발생한 얼굴 신경마비의 임상적 특징과 예후

Clinical characteristics and prognosis of facial nerve palsy in children: an 11-year retrospective study

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Background and Objectives: Bell’s palsy is the most common etiology of acute facial nerve palsy in children. Facial nerve palsy is known to have a better prognosis with younger age. The method and timing of treatment for facial nerve palsy in children is controversial. This study aimed to investigate the clinical outcomes and prognosis in childhood facial nerve palsy. Methods: We conducted a retrospective cohort study of 62 peripheral facial nerve palsy patients under 19 years old who visited our hospital from January 2009 to December 2019. The degree of facial nerve palsy was determined based on the House-Brackmann Facial Nerve Grading Scale. Results: The average age of the patients was 8.9±4.8 years. The most frequent group was 6-12 years old. Bell’s palsy (62.9%) was the most common etiology followed by infection (32.3%), and trauma (4.8%). 34 (54.8%) patients had history of upper respiratory infection within 4 weeks. In 54 patients who were followed up within one month after discharge, grade reduction rate of facial nerve palsy was 88.9% (48/54), and it took a median of 14 days. Furthermore, in 41 patients who were followed up for more than one month after discharge, the complete recovery rate was 93% (38/41), and it took a median of 19.5 days. No significant difference in recovery outcome was detected who were treated within 3 days and after 3 days of symptom onset. Likewise, there was no statistical significance between age and recovery outcome. Three (5.6%) patients had recurrent attacks, one of them was accompanied by headache, eye movement impairment, and hemiplegia, and did not show no significant improvement even 10 years after the onset of first symptom. The recurrence period was 4, 7, and 7 years, respectively. Conclusion: The three major causes of facial nerve palsy are Bell s palsy, infection, and trauma. When comparing the difference in recovery period according to the time of treatment and age, all are not statistically significant. The prognosis of facial nerve palsy in children is good, but long-term follow-up is necessary because it may recur after several years.

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