Serum levels of heavy metals in patients with Bell’s palsy: a case–control study

Bozan N., Koçak Ö. F., Demir C. Y., Avcı K., Erdağ Ö., Turan M., ...More

European Archives of Oto-Rhino-Laryngology, vol.281, no.2, pp.891-896, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 281 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.1007/s00405-023-08253-w
  • Journal Name: European Archives of Oto-Rhino-Laryngology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.891-896
  • Keywords: Bell’s palsy, Essential elements, Facial nerve palsy, Heavy metals
  • Van Yüzüncü Yıl University Affiliated: Yes


Purpose: The exact etiology of Bell’s palsy (BP) remains unknown, while its potential etiopathology includes neuritis and inflammation-related demyelination as in optic neuritis. It has been reported that disruption of heavy metal homeostasis may be associated with the inflammatory process of optic neuritis; therefore, heavy metals may be involved in the pathogenesis of facial nerve neuritis. In this study, we aimed to investigate serum levels of heavy metals including essential elements [iron (Fe), zinc (Zn), copper (Cu), cobalt (Co), and manganese (Mn)], and nonessential elements [lead (Pb) and cadmium (Cd)] in patients with BP. Methods: The study included 25 patients with BP and 31 healthy volunteers. For each participant, serum levels of essential and nonessential elements were measured using the atomic absorption spectrophotometer method. Results: Serum levels of essential elements were significantly lower in the patient group compared to the control group (p < 0.001, for each). Serum levels of Pb increased in the patient group compared to the control group although no significant difference was achieved (p = 0.105). In contrast, serum Cd levels increased significantly in the patient group compared to the control group (p < 0.001). Conclusion: Our findings suggest that decreased essential and increased nonessential elements may be associated with BP and thus, serum concentrations of these elements should be taken into account in BP. Studies are warranted to determine the role of these elements in treatment of BP.