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Comparison of Steroid and Lipoprostaglandin E₁ Therapy

Tomoya Koriyama, MD; Shigeru Inafuku, MD; Kiyoko Kimata, MD; Tatsuyuki Banno, MD; Hiromichi Ishigami, MD

Arch Otolaryngol Head Neck Surg. 2001;127:1338-1340.

Objective  To compare megadose steroid therapy (n = 17; group S) and lipoprostaglandin E₁ (lipo-PGE₁) therapy (n = 14; group L) in patients with recent-onset Bell palsy complicated by diabetes.

Design  A nonrandomized controlled trial was performed. The 2 groups were almost identical in age, sex distribution, and laterality, and there was no difference in the average palsy scores in the 2 groups either at the time of the first visit or when the palsy was at its worst.

Results  There was no statistically significant difference in the cumulative rates of improvement in the 2 groups 4 weeks, 2 months, or 6 months after the first visit, revealing no difference in the therapeutic effects of the 2 agents. During the therapy, fasting blood glucose concentrations were increased in all patients in group S, whereas they were not increased in group L. Complicated diabetes was aggravated in group S, while it was not aggravated in group L.

Conclusions  Lipo-PGE₁ therapy may have improved vascular flow in the facial nerves and accelerated recovery, resulting in a rate of improvement comparable with that obtained through megadose steroid therapy. Lipo-PGE₁ is a useful treatment method for patients with Bell palsy complicated by diabetes.

From the Departments of Otorhinolaryngology, Nagoya Memorial Hospital, Nagoya, Japan (Drs Koriyama and Kimata), and Department of Otorhinolaryngology, Aichi Medical University, School of Medicine, Aichi, Japan (Drs Inafuku, Banno, and Ishigami).

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