Objective: To investigate the use of steroid-induced leukocytosis (SIL) in Bell’s palsy to predict recovery and guide personalized treatment options for patients for the first time in the literature. Material and Methods: In this prospective, observational study, 86 Bell’s palsy patients who received prednisone within 72 hours of symptom onset were observed at a single tertiary referral center between 2017-2022. Leukocyte counts and facial function were assessed during the first 5 days of treatment. Results: The study involved 86 patients, with a mean age of 46.32±11.8 years for the recovery group (n=71) and 48.65±12.07 years for the nonrecovery group (n=16).The results showed a significant effect of time on leukocyte counts (p<0.001), a significant effect of recovery status on leukocyte counts (p=0.044), and a significant interaction between time and recovery status (p=0.014). Subgroup analyses of leukocyte levels indicated that there were significant differences between the nonrecovery and recovery groups on 4 of the predictor variables; peak day (p=0.042), 5-day average (p<0.001), initial increase (p<0.001), and peak-pre level (p<0.049). Binary logistic regression analysis identified 2 predictor variables, the 5-day average [p=0.007, odds ratio (OR): 5.89, Confidence Interval (CI): 1.63-21.24], and the initial increase (p=0.006, OR: 2.29, CI: 1.27-4.13), as statistically significant for the outcome variable. The sensitivity and specificity of the initial increase were 81.7% and 66.2% at a cut-off value of 5.23, respectively. Conclusion: The results of this study provide valuable insights into the usefulness of SIL as a predictor of treatment success in patients with Bell’s’ palsy.

Amaç: Bu çalışmanın amacı, Bell paralizisi hastalarında steroid kaynaklı lökositoz (SKL) kullanarak iyileşmeyi öngörmek ve kişiselleştirilmiş tedavi seçeneklerini ilk kez literatürde araştırmaktır. Gereç ve Yöntemler: Prospektif, gözlemsel bu çalışmada, 2017-2022 yılları arasında semptomların başlangıcından itibaren 72 saat içinde prednizon tedavisi alan 86 Bell paralizisi hastası üçüncü basamak bir hastanede izlenmiştir. Tedavinin ilk 5 günü boyunca lökosit sayıları ve fasiyal fonksiyonları değerlendirilmiştir. Bulgular: Çalışmaya 86 hasta dâhil edilmiştir; iyileşen grubun (n=71) ortalama yaşı 46,32±11,8 yıl, iyileşmeyen grubun (n=16) ortalama yaşı ise 48,65±12,07 yıldır. Sonuçlar, lökosit sayıları üzerinde zamanın (p<0,001) ve iyileşme durumunun (p=0,044) anlamlı etkilerini ve zaman ile iyileşme durumu arasında anlamlı bir etkileşimi (p=0,014) göstermiştir. Lökosit seviyelerinin alt grup analizleri, iyileşmeyen ve iyileşen gruplar arasında 4 prediktör değişkeninde anlamlı farklar olduğunu göstermiştir; zirve gün (p=0,042), 5 günlük ortalama (p<0,001), ilk artış (p<0,001) ve zirve-öncesi seviye (p<0,049). İkili lojistik regresyon analizi, 5 günlük ortalama [p=0,007, odds oranı (OR):5,89, güven aralığı (confidence interval (CI):1,63-21,24] ve ilk artış (p=0,006, OR:2,29, CI:1,27-4,13) olmak üzere 2 prediktör değişkenini sonuç değişkeni için istatistiksel olarak anlamlı bulmuştur. İlk artışın kesilme değeri 5,23’te duyarlılık ve özgüllük sırasıyla %81,7 ve %66,2 olarak bulunmuştur. Sonuç: Bu çalışmanın sonuçları, Bell paralizisi hastalarında tedavi başarısının bir prediktörü olarak SKL’nin faydalı olduğu konusunda değerli bilgiler sunmaktadır.

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