Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2015; 3(2): 180-185
Published online Feb 16, 2015. doi: 10.12998/wjcc.v3.i2.180
Use of steroids for facial nerve paralysis after parotidectomy: A systematic review
Kiran Varadharajan, Issa Beegun, Niall Daly
Kiran Varadharajan, Department of ENT, St. George’s Hospital, SW17 0QT London, United Kingdom
Issa Beegun, Department of ENT, Royal National Throat, Nose and Ear Hospital, WC1X 8DA London, United Kingdom
Niall Daly, Department of ENT, West Middlesex University Hospital, TW7 6AF London, United Kingdom
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest: The authors have no conflicts of interest to declare.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kiran Varadharajan, MRCS, DOHNS, Surgical Teaching Fellow, Department of ENT, St. George’s Hospital, Blackshaw Road, SW17 0QT London, United Kingdom. kiranvarad@doctors.org.uk
Telephone: +44-28-6721123 Fax: +44-20-82666255
Received: October 30, 2014
Peer-review started: October 30, 2014
First decision: December 12, 2014
Revised: December 27, 2014
Accepted: January 9, 2015
Article in press: January 12, 2015
Published online: February 16, 2015
Processing time: 98 Days and 8 Hours
Abstract

AIM: To systematically review the literature to assess the efficacy of corticosteroids in treating post-parotidectomy facial nerve palsy (FNP).

METHODS: We searched the Cochrane library, EMBASE and MEDLINE (from inception to 2014) for studies assessing the use of corticosteroids in post-parotidectomy FNP. Studies were assessed for inclusion and quality. Data was extracted from included studies.

RESULTS: Two randomised controlled trials met the inclusion criteria. One study assessed the use of dexamethasone and the other prednisolone. None of the studies demonstrated a significant difference in the outcome of FNP post-parotidectomy with the use of corticosteroids vs no therapy. The majority of FNP post-parotidectomy is transient. Preoperative factors (size of tumour and malignancy), intraoperative factors (extent of parotidectomy and integrity of facial nerve at the end of the operation) are important in determining prognosis of FNP if it does occur.

CONCLUSION: Corticosteroids do not appear to improve FNP prognosis post-parotidectomy. Further studies assessing patients by cohort and with long term follow-up are required to increase scientific evidence.

Keywords: Adrenal cortex hormones; Facial paralysis; Parotid diseases; Steroids

Core tip: Parotidectomy is a common operation performed to treat benign and malignant parotid lesions. Facial nerve palsy (FNP) is a well documented complication of parotidectomy that can significantly impair quality of life. Steroids have been proposed as a treatment option for post-parotidectomy FNP. In this systematic review of randomised controlled trials, we found minimal evidence to suggest steroids improve the prognosis of FNP after parotidectomy. However, more trials are required to assess the effectiveness of steroids in specific cohorts of patients.