{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:24:50Z","timestamp":1786969490709,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate Bell's palsy incidence and evaluate the prevalence and associations with diabetes and other cardiometabolic conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Population\u2010based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Clalit Health Services, the largest healthcare provider organization in Israel (2005\u20102022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Bell's palsy cases were identified by ICD\u201010 code G51.0 (n\u2009=\u200911,255). To optimize specificity, individuals with secondary facial palsy codes or competing acute etiologies within \u00b130 days were excluded. Members without Bell's palsy served as controls. Annual incidence per 100,000 person\u2010years. Multivariable logistic regression adjusted for age, gender, socioeconomic status, and ethnicity; Bonferroni correction applied. Age\u2010stratified and \u226540\u2010year sensitivity analyses were performed. Systemic corticosteroid dispensing was evaluated in peri\u2010index and extended capture windows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5,489,298 members, 11,255 were diagnosed with Bell's palsy (median age, 51 years); about one\u2010third occurred at ages 50 to 69 years. Incidence was ~18 per 100,000 person\u2010years. Diabetes was more prevalent among cases than controls (21% vs 6%; standardized mean difference [SMD]\u2009=\u20090.45) and independently associated with Bell's palsy (adjusted odds ratio [aOR], 1.63), persisting across age groups and in the \u226540\u2010year sensitivity analysis. Diabetic retinopathy and nephropathy were also associated (aOR 1.97 and 1.41). Stroke, smoking and obesity were also independently associated with Bell's palsy. Hypertension was more prevalent among cases but was not independently associated after Bonferroni correction and age\u2010restricted analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bell's palsy incidence remained stable throughout the 18\u2010year study period and was associated with diabetes and diabetes\u2010related complications. While current guidelines do not recommend routine HbA1c testing in patients with Bell's palsy, our findings support considering targeted diabetes screening and assessment of glycemic status and diabetes\u2010related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70388","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:27:20Z","timestamp":1786966040000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bell's Palsy in 11,255 Cases: Cardiometabolic Associations in a Population\u2010Based Healthcare Database"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1839-7344","authenticated-orcid":false,"given":"Tomer","family":"Boldes","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Meir Medical Center Kfar Saba Israel"},{"name":"Gray School of Medical Sciences, Faculty of Medical and 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