Elevated neutrophil-to-lymphocyte ratio in Bell's palsy and its correlation with facial nerve enhancement on MRI

Abstract

Objective. The aim of this study was to investigate the role of inflammation and atherothrombosis in Bell's palsy (BP) by using neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), respectively, and to study their relations with the facial nerve enhancement on temporal gadolinium-enhanced magnetic resonance imaging (TGd-MRI). Study Design. Case control study. Setting. Tertiary health institution. Subjects and Methods. This study was performed on 65 patients who were diagnosed with BP and a control group of 35 healthy individuals. The BP patients were also divided into 2 groups, those with facial nerve enhancement on TGd- MRI and those without enhancement. The NLR and MPV of each group were compared. Results. The NLRs of the BP patients were significantly higher than control group (P = .001). The NLRs of patients with facial nerve enhancement on TGd-MRI were significantly higher than patients without enhancement (P = .001). There was a positive and significant correlation between NLR and House-Brackmann (HB) grade of the patients (r = 0.641; P<.05). MPV did not show any significant correlation with any of the parameters studied (P .05). Conclusion. NLR can be used as a new and important marker in BP since it is high in BP patients and significantly correlated with HB grade and facial nerve enhancement on TGd- MR. On the other hand, MPV does not have such correlations. These results offer evidence to support an inflammatory theory rather than microvascular response theory in the etiopatogenesis of BP. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.