Evaluation of the Relationship Between Homocysteine, Vitamin B12, and Folate Levels and Disease Stages in Patients with Bell’s Palsy Bell Paralizisi Olan Hastalarda Homosistein, Vitamin B12 ve Folat Düzeyleri ile Hastalık Evreleri Arasındaki İlişkinin Değerlendirilmesi

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Karakuş M. F., Gül T., Kaya M., Enginyurt Ö., Çankaya S., Cihan M.

Journal of Ear Nose Throat and Head Neck Surgery, cilt.34, sa.3, ss.201-208, 2026 (Scopus, TRDizin)

Özet

Objective: Evidence suggests that inflammation and edema in the vasa nervorum contribute to the etiology of Bell’s palsy. Our article aims to evaluate whether vitamin B12, folate, and homocysteine levels are associated with disease severity. Material and Methods: In this retrospective study, the demographic, clinical, and laboratory findings of 73 adult patients with Bell’s palsy of both sexes were reviewed. Patients with systemic metabolic diseases with elevated homocysteine levels and recurrent cases previously treated for paralysis were excluded. Patients were graded using the House-Brackmann Facial Nerve Grading System. The relationship between age, gender, homocysteine, vitamin B12, and folate levels, and disease stage were determined. Results: The mean homocysteine levels were 12.4±3.21, 16.7±5.02, and 19.6±3.31 µmol/L in patients with Grades 3, 4, and 5, respectively, with significant differences among grades (p<0.001). Homocysteine levels in patients with Grade 5 were significantly higher than those with Grade 3 (p<0.001), and Grade 4 levels were higher than Grade 3 (p=0.003); the difference between Grades 4 and 5 was not significant (p=0.056). Furthermore, a one-unit increase in homocysteine levels was associated with a 1.37-fold higher odds of being in a more severe grade (p<0.001). Conclusion: Our findings indicate a significant and positive association between homocysteine levels and the severity of Bell’s palsy. In contrast, vitamin B12 and folate levels were not significantly predictive of this relationship, suggesting that homocysteine is a useful biomarker for assessing disease severity.