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Video

Facial Plastic and Reconstructive Surgery

(A409) Demographic Disparities in Diagnostic Imaging and Treatment of Bell’s Palsy: Employer-Sponsored Claims Analysis

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters
Has Audio

    Presenting Author(s)

  • Sujay Ratna, B.S.

    Medical Student
    Icahn School of Medicine At Mount Sinai
    New York, New York, United States

    • Co-Author(s)

  • Rahul Sharma, MD

    Resident Physician
    Vanderbilt University Medical Ctr
    Nashville, Tennessee, United States

  • JR

    Joshua Rosenberg, MD

    Icahn School of Medicine at Mount Sinai, United States

    • Senior Author(s)

  • MG

    Mingyang L. Gray, MD, MPH

    Assistant Professor
    New York Eye & Ear Infirmary of Mount Sinai
    New York, NY, United States

Disclosure(s):
Sujay Ratna, B.S.: No relevant relationships to disclose.


Introduction: Bell’s palsy, with its broad spectrum of clinical presentations and management approaches, is prone to disparities in treatment, underscoring the importance of understanding and addressing variability in its care. This study investigates the frequencies of diagnostic imaging (CT and MRI) and treatment types in Bell's palsy patients, analyzing their correlation with regional distribution, age, and gender.

Methods: We conducted a retrospective cohort study of adult Bell’s palsy patients using ICD-9 and 10 diagnosis codes from 2016-2021 in the MarketScan database. Patients with non-idiopathic causes of Bell’s palsy, such as Lyme disease, malignancies, autoimmunity, or iatrogenic facial paralysis, were excluded. Treatment groups were defined as no treatment, monotherapy (steroid or antiviral), or combination therapy (steroid and antivirals).

Results: After applying these inclusion and exclusion criteria, the final cohort included 35,942 individuals with idiopathic Bell’s palsy.
Most patients in our cohort were treated in the Southern United States (N = 17,041, 47%). The regional distribution of the remaining cases included North Central (19%, 6,791 cases), Northeast (17%, 6,175 cases), and West (16%, 5,804 cases). Furthermore, regional differences and gender have statistically significant effects on the likelihood of receiving treatment. The South and West regions exhibit higher odds of receiving combination therapy (OR 1.10 and 1.23, respectively), both significant. Female patients have significantly lower odds of receiving combination therapy (OR = 0.73, p < 0.001) compared to males. Patients’ age showed no significant association with the odds of receiving combination therapy (OR 1.00, p = 0.105).

Conclusions: This study highlights significant regional and gender disparities in the diagnostic imaging and treatment of Bell’s palsy, with patients in the South and West more likely to receive combination therapy, emphasizing the need to address variability in care to ensure equitable treatment.