Ear, Nose and Throat Disorders

Aim: Comparison of acyclovir and famciclovir in the treatment of Bell’s palsy is uncertain. Therefore, aim of this study was to evaluate which antiviral agent provided better recovery outcomes in patients with Bell’s palsy.

Methods: The study cohort consisted of patients with facial palsy who visited the outpatient clinic between January 2006 and January 2014. Patients were treated with prednisolone plus either acyclovir (n=457) or famciclovir (n=245). Patient outcomes were measured using the House-Brackmann scale according to initial severity of disease and underlying disease.

Result: The overall recovery rate tended to be higher in the famciclovir than in the acyclovir group. The rate of recovery in patients

with initially severe facial palsy (grades V and VI) was significantly higher in the famciclovir than in the acyclovir group (p=0.01), whereas the rates of recovery in patients with initially moderate palsy (grade III–IV) were similar in the two groups. Conclusion: The overall recovery rates in patients without hypertension or diabetes mellitus were higher in the famciclovir than in the acyclovir group, but the difference was not statistically significant. Treatment with steroid plus famciclovir was more effective

than treatment with steroid plus acyclovir in patients with severe facial palsy. Famciclovir may be the antiviral agent of choice in the treatment of patients with severe facial palsy.