Clin Exp Otorhinolaryngol.  2019 Aug;12(3):261-266. 10.21053/ceo.2018.01018.

Association Between High Neutrophil to Lymphocyte Ratio and Delayed Recovery From Bell's Palsy

  • 1Department of Otolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University, Seoul, Korea.
  • 2Department of Anatomy and Neurobiology, School of Medicine, Kyung Hee University, Seoul, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea.


Factors predictive of the severity of and recovery from Bell's palsy remain unclear. This study evaluated the association between neutrophil to lymphocyte ratio (NLR) and the severity of and recovery from Bell's palsy.
This retrospective study included 51 patients who were hospitalized with Bell's palsy from 2015 to 2017. Degree of paralysis was assessed by House-Brackmann (H-B) grade. Patients with H-B grades 2-4 were classified as having mild to moderate palsy and patients with H-B grade 5 or 6 were classified as having severe palsy. Patients were evaluated for obesity, hypertension and diabetes mellitus, and blood tests were performed to determine NLR and platelet to lymphocyte ratio. Patients were treated with steroids and antiviral agents. H-B grade was assessed 1 week, 1 month, and 3 months after treatment.
NLR was significantly higher in patients with severe than with mild to moderate palsy (P=0.048). Recovery time was significantly longer in patients with high NLR than low NLR (P=0.045).
Higher NLR in patients with Bell's palsy was associated with longer recovery time. NLR may be prognostic of recovery time in patients with Bell's palsy.


Neutrophils; Lymphocytes; Bell Palsy; Facial Paralysis
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