{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:00:42Z","timestamp":1784696442260,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We characterize occult lesion diagnosis rates after initial Bell's palsy diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A de\u2010identified database of all facial palsy patients who presented to an extensive health care system across 22\u2009years was created using Epic SlicerDicer. Among patients with Bell's palsy diagnoses, we extracted demographic and any subsequent occult lesion diagnosis data across various clinical sites. Descriptive and multivariable regression analyses comparing patients with occult lesion diagnoses made at different time points were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the total 3912 facial palsy patients, 2240 had Bell's palsy diagnoses, of which 217 (9.7%) had subsequent lesion diagnoses at a median (IQR) of 12.3 (4.2, 23.8) months, consisting of cranial nerve neoplasms (62.2%), parotid gland neoplasms (34.1%), and cholesteatomas (3.7%). Although a large proportion of total lesions were diagnosed within the first 3\u2009months (19.8%), 69.5% were diagnosed after 6\u2009months. There were no demographic differences among patients diagnosed with different lesion types, but Asian patients were more likely to be diagnosed with occult lesions after 12\u2009months after Bell's palsy diagnosis compared with white patients (odds ratio\u2009=\u20096.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In one of the largest Bell's palsy cohorts to date, we identified a 9.7% occult lesion diagnosis rate at a median of 12.3\u2009months after Bell's palsy diagnosis. These data underscore the importance of timely workup for occult lesions in cases of facial palsy with no signs of recovery after 3\u20134\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:911\u2013918, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30895","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T10:29:54Z","timestamp":1689848994000},"page":"911-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Rate of Occult Lesion Diagnosis in a Large Bell's Palsy Cohort"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0485-9042","authenticated-orcid":false,"given":"Sandhya","family":"Kalavacherla","sequence":"first","affiliation":[{"name":"School of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Du","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"de Cos","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9013-8227","authenticated-orcid":false,"given":"Leo","family":"Meller","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8187-8557","authenticated-orcid":false,"given":"Benjamin","family":"Ostrander","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head &amp; Neck Surgery University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.19837"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(72)91499-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1726358"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556139607500608"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.15761\/NNS.1000134"},{"key":"e_1_2_6_7_1","first-page":"1204","article-title":"Bell's palsy","volume":"2011","author":"Holland J","year":"2011","journal-title":"BMJ Clin Evid"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.2832"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.06.022"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.889876"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4665-x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.2142"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115000687"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24542"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2009.04.003"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-022-00591-9"},{"issue":"11","key":"e_1_2_6_17_1","first-page":"817","article-title":"Misdiagnosis of facial nerve tumor","volume":"42","author":"Zhang R","year":"2007","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.09.005"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-015-1827-9"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1734356"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.13201\/j.issn.1001-1781.2016.20.006"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.12.001"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1992.01880040093015"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43163-021-00151-4"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480500265950"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106003227"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198803000-00007"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.3342\/ceo.2015.8.3.218"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005632"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.3747\/co.27.6547"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.5.JNS101597"},{"issue":"7","key":"e_1_2_6_32_1","first-page":"997","article-title":"Bell's palsy: diagnosis and management","volume":"76","author":"Tiemstra JD","year":"2007","journal-title":"Am Fam Physician"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.2217\/fnl.14.55"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1993.01880140111017"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1259\/dmfr\/21825064"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57080836"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3690"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-022-00924-0"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-693"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06463-0"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2013.1382"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T06:09:37Z","timestamp":1705903777000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/lary.30895"],"URL":"https:\/\/doi.org\/10.1002\/lary.30895","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,20]]},"assertion":[{"value":"2023-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}