FFinalistSouthampton · 2027
The drug atlas
ENT/Corticosteroids in ENT

Steroids in ENT (Bell's palsy / sudden SNHL)

also: prednisolone Bell's palsy · sudden sensorineural hearing loss · facial palsy

Overview

Two time-critical steroid indications in ENT — Bell's palsy and idiopathic sudden sensorineural hearing loss — where early oral steroids change the outcome.

Mechanism

Glucocorticoid reduces neural/cochlear inflammation and oedema. The benefit is time-dependent — given early in Bell's palsy and sudden SNHL.

Indications

  • Bell's palsy (within 72 h of onset)
  • Idiopathic sudden sensorineural hearing loss
  • Severe croup (dexamethasone — cross-ref Child Health)

The agents

Prednisolone (Bell's palsy)oral

within 72 h

e.g. 50 mg OD 10 days; antivirals only added if severe. MUST add eye care (lubricants, tape at night) — exposure keratopathy.

High-dose prednisolone (sudden SNHL)oral

urgent ENT referral

e.g. 60 mg OD 7 days then taper; an ENT emergency — refer immediately + MRI to exclude acoustic neuroma.

Adverse effects

Standard glucocorticoid effectscommon

Hyperglycaemia, mood, insomnia — see Corticosteroids card.

Bell's palsy: corneal exposure if eye care omittedserious

Cautions & contraindications

UMN facial weakness (forehead spared)all

That is a stroke, not Bell's palsy — refer to stroke, do not just give steroids.

Systemic infection (relative)all

Interactions

  • As corticosteroids

Monitoring & kinetics

Bell's palsy: eye protection + recovery (80% recover in 3–4 months); sudden SNHL: audiometry

Oral, started as early as possible.

Source: NICE CKS — Bell's palsy · BNF — Corticosteroids