Steroids are indicated if paralysis is complete and no contraindications exist

Editor-Devine's letter about treatment of facial nerve paralysis, which commented on the case that we reported in Minerva, was inaccurate and misleading.1 Steroids are not contraindicated in the management of herpes zoster. Wood et al and Whitley et al showed in double blind controlled trials that prednisolone significantly reduced pain in the acute phase of the disease at days 7 and 14 and resulted in significantly faster healing of vesicles.2 3 The use of steroids in any facial palsy (Bell's or Ramsay Hunt) is controversial. Most otologists, however, would support their use when the palsy is complete. This is our policy. We treat facial palsy due to herpes zoster with aciclovir, with or without steroids. In this case the patient had …