A 41-year-old man complains of right ear pain, difficulty closing his right eye, and drooping of the right side of his face. He finds that his right ear is sensitive to loud, low frequency sounds. When a small spoonful of sugar is applied to the right side of his tongue, he says that it tastes like sand. The physical examination identifies right-sided weakness of the upper and lower face. The patient's symptoms started 2 days ago. Which of the following is the most appropriate treatment at this time?

Choice A reason: Aspirin is not indicated for acute peripheral facial nerve palsy and would not address inflammation or nerve edema causing symptoms. Choice B reason: Antibiotics are indicated for bacterial infections, but the acute onset and clinical features suggest idiopathic peripheral facial nerve palsy (Bell’s palsy), not infection. Choice C reason: Surgery is rarely indicated for Bell’s palsy and is reserved for severe, refractory cases; immediate intervention is not warranted. Choice D reason: Corticosteroids reduce inflammation and edema of the facial nerve and are the first-line treatment for Bell’s palsy, particularly within 72 hours of symptom onset, making this the most appropriate intervention.