New Predictive Parameters of Bell’s Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

Bell's palsy (BP) is the most frequent cause of unilateral facial paralysis at a rate of 60-75% (1).It may appear in all stages of life, most often heals completely and may recur with various severity in 15% of patients (2,3).The pathogenesis of BP is not clear; however, inflammation and viral infections are thought to play an important role (4).As a result of inflammation, edema occurs in the fallopian tubes, especially in the labyrinth segment (5).A hemogram of peripheral blood can be used to determine neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR).PLR was found to be high in several peripheral vascular diseases, coronary artery diseases and some gynecological and hepatobiliary malignancies and was associated with poor prognosis.NLR may increase in systemic inflammation, some gynecological and gastrointestinal cancers and some cardiovascular diseases (6-8).Background: Bell's palsy is the most frequent cause of unilateral facial paralysis.Inflammation is thought to play an important role in the pathogenesis of Bell's palsy.Aims: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are simple and inexpensive tests which are indicative of inflammation and can be calculated by all physicians.The aim of this study was to reveal correlations of Bell's palsy and degree of paralysis with NLR and PLR. Study Design: Case-control study.Methods: The retrospective study was performed January 2010 and December 2013.Ninety-nine patients diagnosed as Bell's palsy were included in the Bell's palsy group and ninety-nine healthy individuals with the same demographic characteristics as the Bell's palsy group were included in the control group.As a result of analyses, NLR and PLR were calculated.Results: The mean NLR was 4.37 in the Bell's palsy group and 1.89 in the control group with a statistically significant difference (p<0.001).The mean PLR was 137.5 in the Bell's palsy group and 113.75 in the control group with a statistically significant difference (p=0.008).No statistically significant relation was detected between the degree of facial paralysis and NLR and PLR.Conclusion: The NLR and the PLR were significantly higher in patients with Bell's palsy.This is the first study to reveal a relation between Bell's palsy and PLR.NLR and PLR can be used as auxiliary parameters in the diagnosis of Bell's palsy.