Retrospective analysis of factors affecting the prognosis of Bell's palsy: A two-center study based on data from 94 patients

doi:10.12439/kqhm.1005-4979.2026.01.004

《Journal of Oral and Maxillofacial Surgery》 ›› 2026, Vol. 36 ›› Issue (1): 27-33. doi: 10.12439/kqhm.1005-4979.2026.01.004

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Retrospective analysis of factors affecting the prognosis of Bell's palsy: A two-center study based on data from 94 patients

SIQIN Gaowa¹(), LI Chenxi²^,³(), HUANG Dishu⁴, WANG Yue⁵, GONG Zhongcheng²

^1. Department of Oral Radiology,the First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital), Urumqi 830054
^2. Department of Oral and Maxillofacial Oncology & Surgery, the First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital), Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054
³ Clinical Medicine Postdoctoral Scientific Research Station, Xinjiang Medical University, Urumqi 830054
⁴ Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014
⁵ Department of Maxillofacial Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China

Received:2024-11-27 Accepted:2024-12-27 Published:2026-02-28 Online:2026-02-13
Contact: LI Chenxi

贝尔面瘫预后影响因素的回顾性分析：基于双中心94例患者资料

斯琴高娃¹(), 李晨曦²^,³(), 黄迪书⁴, 王玥⁵, 龚忠诚²

^1. 新疆医科大学第一附属医院（附属口腔医院）口腔影像科，乌鲁木齐 830054
^2. 新疆医科大学第一附属医院（附属口腔医院）口腔颌面肿瘤外科，新疆维吾尔自治区口腔医学研究所，乌鲁木齐 830054
³ 新疆医科大学临床医学博士后科研流动站，乌鲁木齐 830054
⁴ 重庆医科大学附属儿童医院神经内科，国家儿童健康与疾病临床医学研究中心，中国儿童健康发展与危重症国际科技合作基地，儿童发育疾病研究教育部重点实验室，重庆医科大学附属儿童医院儿研所重点实验室，重庆 400014
⁵ 新疆维吾尔自治区人民医院颌面外科，乌鲁木齐 830001

通讯作者: 李晨曦
作者简介:
斯琴高娃，住院医师. E-mail: 1258237001@qq.com
基金资助:
新疆战略人才培养计划一流科技领军人才项目(XJRC-2025-KJ-PY-KJLJ-118); 新疆维吾尔自治区自然科学基金(2025D01C175)

Abstract

Key words: Bell's palsy, logistic regression analysis, prognostic factors, treatment modalities

关键词: 贝尔面瘫, logistic回归分析, 预后因素, 治疗方式

SIQIN Gaowa, LI Chenxi, HUANG Dishu, WANG Yue, GONG Zhongcheng. Retrospective analysis of factors affecting the prognosis of Bell's palsy: A two-center study based on data from 94 patients[J]. 《Journal of Oral and Maxillofacial Surgery》, 2026, 36(1): 27-33.

斯琴高娃, 李晨曦, 黄迪书, 王玥, 龚忠诚. 贝尔面瘫预后影响因素的回顾性分析：基于双中心94例患者资料[J]. 《口腔颌面外科杂志》, 2026, 36(1): 27-33.

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URL: https://journal06.magtech.org.cn/Jweb_joms/EN/10.12439/kqhm.1005-4979.2026.01.004

https://journal06.magtech.org.cn/Jweb_joms/EN/Y2026/V36/I1/27

Figures/Tables 6

References 27

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[2]	Evangelista V, Gooding MS, Pereira L. Bell's palsy in pregnancy[J]. Obstet Gynecol Surv, 2019, 74(11): 674-678.
[3]	Peitersen E. Bell's palsy: The spontaneous course of 2, 500 peripheral facial nerve palsies of different etiologies[J]. Acta Otolaryngol Suppl, 2002(549): 4-30.
[4]	Gilden DH. Clinical practice. Bell's Palsy[J]. N Engl J Med, 2004, 351(13): 1323-1331.
[5]	Julian Holland N, Weiner GM. Recent developments in Bell's palsy[J]. BMJ, 2004, 329(7465): 553-557.
[6]	Dong SH, Jung AR, Jung J, et al. Recurrent Bell's palsy[J]. Clin Otolaryngol, 2019, 44(3): 305-312.
[7]	Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's Palsy executive summary[J]. Otolaryngol Head Neck Surg, 2013, 149(5): 656-663.
[8]	Gagyor I, Madhok VB, Daly F, et al. Antiviral treatment for Bell's palsy (idiopathic facial paralysis)[J]. Cochrane Database Syst Rev, 2015(11): CD001869.
[9]	Fieux M, Franco-Vidal V, Devic P, et al. French Society of ENT (SFORL) guidelines. Management of acute Bell's palsy[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2020, 137(6): 483-488.
[10]	de Almeida JR, Guyatt GH, Sud S, et al. Management of Bell palsy: Clinical practice guideline[J]. CMAJ, 2014, 186(12): 917-922.
[11]	Sathirapanya P, Sathirapanya C. Clinical prognostic factors for treatment outcome in Bell's palsy: A prospective study[J]. J Med Assoc Thai, 2008, 91(8): 1182-1188.
[12]	Kınar A, Ulu Ş, Bucak A, et al. Can Systemic Immune-Inflammation Index (SII) be a prognostic factor of Bell's palsy patients?[J]. Neurol Sci, 2021, 42(8): 3197-3201.
[13]	Urban E, Volk GF, Geißler K, et al. Prognostic factors for the outcome of Bells' palsy: A cohort register-based study[J]. Clin Otolaryngol, 2020, 45(5): 754-761.
[14]	Braillon A, Naudet F. STROBE and pre-registration of observational studies[J]. BMJ, 2023, 380: 90.
[15]	Huang B, Zhou ZL, Wang LL, et al. Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy: A comparative study[J]. J Integr Med, 2014, 12(4): 367-371.
[16]	Baugh RF, Basura GJ, Ishii L, et al. Clinical practice guideline: Bell's palsy[J]. Otolaryngol—head Neck Surg, 2013, 149(S2): 1-27.
[17]	Berg T, Jonsson L. Peripheral neuropathies: Corticosteroids and antivirals in Bell palsy[J]. Nat Rev Neurol, 2013, 9(3): 128-129.
[18]	Sullivan FM, Swan IRC, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell's palsy[J]. N Engl J Med, 2007, 357(16): 1598-1607.
[19]	Yamamoto K, Kurioka T, Ohki M, et al. Immune-nutritional status as a novel prognostic predictor of Bell's palsy[J]. Audiol Neurootol, 2022, 27(5): 418-426.
[20]	Yoo MC, Park DC, Byun JY, et al. Clinical prognostic factors associated with good outcomes in pediatric Bell's palsy[J]. J Clin Med, 2021, 10(19): 4368.
[21]	Fujiwara T, Hato N, Kasahara T, et al. Summary of Japanese clinical practice guidelines for Bell's palsy (idiopathic facial palsy)-2023 update edited by the Japan Society of Facial Nerve Research[J]. Auris Nasus Larynx, 2024, 51(5): 840-845.
[22]	Sullivan F, Daly F, Gagyor I. Antiviral agents added to corticosteroids for early treatment of adults with acute idiopathic facial nerve paralysis (Bell palsy)[J]. JAMA, 2016, 316(8): 874-875.
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级别	损伤程度	临床特征
Ⅵ级	完全丧失功能	面部不对称，无运动
Ⅴ级	重度功能障碍	静止状态：不对称运动状态：额部——无运动；眼部——闭合不完全；口唇——仅有轻微运动
Ⅳ级	中重度功能障碍	静止状态：面部对称，张力正常运动状态：额部——无运动；眼部——闭合不完全；口唇——尽力仍有口角下垂不对称大体观察：仅有非常轻微的可察觉的运动
Ⅲ级	中度功能障碍	静止状态：面部对称，张力正常运动状态：额部——轻度至中度运动；眼部——用力可完全闭合眼睑；口唇——尽力仍有轻度鼓腮漏气大体观察：明显的无力和/或影响外观的不对称
Ⅱ级	轻度功能障碍	静止状态：面部对称，张力正常运动状态：额部——中度运动至良好；眼部——轻度用力可完全闭合；口唇——轻度不对称大体观察：面部两侧有明显差异但不影响外观，可见显著但不严重的连带运动、痉挛和/或半侧面肌痉挛
Ⅰ级	正常	所有面部功能正常大体观察：眼睑闭合，检查时轻度无力，可有非常轻微的连带运动

级别	损伤程度	临床特征
Ⅵ级	完全丧失功能	面部不对称，无运动
Ⅴ级	重度功能障碍	静止状态：不对称运动状态：额部——无运动；眼部——闭合不完全；口唇——仅有轻微运动
Ⅳ级	中重度功能障碍	静止状态：面部对称，张力正常运动状态：额部——无运动；眼部——闭合不完全；口唇——尽力仍有口角下垂不对称大体观察：仅有非常轻微的可察觉的运动
Ⅲ级	中度功能障碍	静止状态：面部对称，张力正常运动状态：额部——轻度至中度运动；眼部——用力可完全闭合眼睑；口唇——尽力仍有轻度鼓腮漏气大体观察：明显的无力和/或影响外观的不对称
Ⅱ级	轻度功能障碍	静止状态：面部对称，张力正常运动状态：额部——中度运动至良好；眼部——轻度用力可完全闭合；口唇——轻度不对称大体观察：面部两侧有明显差异但不影响外观，可见显著但不严重的连带运动、痉挛和/或半侧面肌痉挛
Ⅰ级	正常	所有面部功能正常大体观察：眼睑闭合，检查时轻度无力，可有非常轻微的连带运动

研究变量	中心一(n=59)	中心二(n=35)	总计(n=94)	χ²值	P值
年龄/岁				0.046	0.831
≤50	30(50.8)	17(48.6)	47(50.0)
>50	29(49.2)	18(51.4)	47(50.0)
性别				1.782	0.182
男	32(54.2)	14(40.0)	46(48.9)
女	27(45.8)	21(60.0)	48(51.1)
吸烟史	24(40.7)	10(28.6)	34(36.2)	1.395	0.238
合并高血压	25(42.4)	17(48.6)	42(44.7)	0.341	0.559
合并糖尿病	32(54.2)	14(40.0)	46(48.9)	1.782	0.182
血脂异常	17(28.8)	8(22.9)	25(26.6)	0.399	0.527
累及患侧				0.232	0.630
左侧	30(50.8)	16(45.7)	46(48.9)
右侧	29(49.2)	19(54.3)	48(51.1)
H-B分级				3.761	0.052
Ⅱ级	20(33.9)	19(54.3)	39(41.5)
Ⅲ~Ⅵ级	39(66.1)	16(45.7)	55(58.5)

研究变量	中心一(n=59)	中心二(n=35)	总计(n=94)	χ²值	P值
年龄/岁				0.046	0.831
≤50	30(50.8)	17(48.6)	47(50.0)
>50	29(49.2)	18(51.4)	47(50.0)
性别				1.782	0.182
男	32(54.2)	14(40.0)	46(48.9)
女	27(45.8)	21(60.0)	48(51.1)
吸烟史	24(40.7)	10(28.6)	34(36.2)	1.395	0.238
合并高血压	25(42.4)	17(48.6)	42(44.7)	0.341	0.559
合并糖尿病	32(54.2)	14(40.0)	46(48.9)	1.782	0.182
血脂异常	17(28.8)	8(22.9)	25(26.6)	0.399	0.527
累及患侧				0.232	0.630
左侧	30(50.8)	16(45.7)	46(48.9)
右侧	29(49.2)	19(54.3)	48(51.1)
H-B分级				3.761	0.052
Ⅱ级	20(33.9)	19(54.3)	39(41.5)
Ⅲ~Ⅵ级	39(66.1)	16(45.7)	55(58.5)

临床因素	例数（占比/%）		χ²值	P值
临床因素	完全恢复（n=78）	部分恢复（n=16）	χ²值	P值
年龄/岁			1.205	0.272
≤50	41(52.6)	6(37.5)
>50	37(47.4)	10(62.5)
性别			2.414	0.120
男	41(52.6)	5(31.3)
女	37(47.4)	11(68.7)
累及患侧			1.009	0.315
左侧	40(51.3)	6(37.5)
右侧	38(48.7)	10(62.5)
吸烟史			5.790	0.016
无	54(69.2)	6(37.5)
有	24(30.8)	10(62.5)
高血压			7.171	0.007
无	48(61.5)	4(25.0)
有	30(38.5)	12(75.0)
糖尿病			8.057	0.005
无	45(57.7)	3(18.8)
有	33(42.3)	13(81.2)
血脂异常			0.608	0.436
无	56(71.8)	13(81.2)
有	22(28.2)	3(18.8)
H-B分级			6.675	0.010
Ⅱ级	37(47.4)	2(12.5)
Ⅲ~Ⅵ级	41(52.6)	14(87.5)

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Retrospective analysis of factors affecting the prognosis of Bell's palsy: A two-center study based on data from 94 patients

贝尔面瘫预后影响因素的回顾性分析：基于双中心94例患者资料

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治疗方式	例数（占比/%）		χ²值	P值
治疗方式	完全恢复（n=78）	部分恢复（n=16）	χ²值	P值
是否接受物理治疗			0.052	0.819
是	68(87.2)	13(81.3)
否	10(12.8)	3(18.7)
药物治疗方案			0.504	0.478
单独使用皮质类固醇	7(9.0)	3(18.7)
皮质类固醇联合抗病毒药物	71(91.0)	13(81.3)

预后因素	β值	标准误	Wald值	OR值(95% CI)	P值
年龄/岁
>50 vs ≤50	0.845	0.746	1.280	2.327(0.539~10.052)	0.258
性别
女 vs 男	1.239	0.800	2.401	3.452(0.720~16.542)	0.121
吸烟史
是 vs 否	2.116	0.817	6.711	8.295(1.674~41.115)	0.010
高血压
是 vs 否	2.269	0.852	7.096	9.667(1.821~51.309)	0.008
糖尿病
是 vs 否	0.726	0.886	0.671	2.066(0.364~11.736)	0.413
血脂异常
是 vs 否	-1.050	0.935	1.263	0.350(0.056~2.185)	0.261
累及患侧
右侧 vs 左侧	0.960	0.714	1.809	2.327(0.645~10.586)	0.179
H-B分级^①
Ⅲ~Ⅵ级 vs Ⅱ级	2.208	1.028	4.611	9.094(1.213~68.209)	0.032

预测变量	AUC (95%CI)	P值
吸烟	0.67(0.53~0.82)	0.03
高血压	0.68(0.54~0.82)	0.02
H-B分级	0.68(0.55~0.81)	0.03

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Retrospective analysis of factors affecting the prognosis of Bell's palsy: A two-center study based on data from 94 patients

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