Relationship between serum gonadal hormone levels and synkinesis in postmenopausal women and man with idiopathic facial paralysis.

Objective: To investigate whether serum gonadal hormone levels are correlated to the development of facial synkinesis following Bell's palsy in postmenopausal women and man.

Methods: A total of 149 patients with Bell's palsy were enrolled in this study. All patients were instructed in standard treatment strategy by expert staff from their first visit. The degree of synkinesis was evaluated at 12 months after the onset of facial nerve palsy based on the synkinesis scores of Sunnybrook facial grading system. The patients were divided into two groups by gender.

Results: Serum estradiol levels were significantly higher in patients with facial synkinesis than in patients without facial synkinesis following Bell's palsy in postmenopausal female. Male patients with facial synkinesis following Bell's palsy had a higher serum estradiol and testosterone levels. Baseline ENoG values (OR=11.144, 95% CI=1.001-124.126, p=0.008) and serum estradiol levels (OR=1.145, 95% CI=1.033-1.270, p=0.010) were the two independent predictors for facial synkinesis in postmenopausal female patients. Meanwhile, baseline ENoG values (OR=5.312, 95% CI=0.626-45.069, p=0.035), HbA1c values (OR=27.470, 95% CI=2.001-43.084, p=0.016), serum E2 levels (OR=1.298, 95% CI=1.092-1.542, p=0.003), and serum testosterone levels (OR=1.892, 95% CI=1.309-2.734, p=0.001) were the independent predictors for facial synkinesis in male patients.

Conclusion: Serum estradiol levels are associated with the development of facial synkinesis following Bell's palsy in postmenopausal female patients. Serum estradiol and testosterone levels are associated with the development of facial synkinesis following Bell's palsy in male patients. Serum gonadal hormone levels might be acted as potential biomarker for predicting facial synkinesis following Bell's palsy.