Thirty-five of 1,488 pediatric otologic cases had congenital facial nerve weakness. A cause was generally not found, but two probably had nuclear dysgenesis; one may have had an intracanalicular lesion; two cases resulted from teratogens, one from poor intrauterine environment, and three from genetic complications. Five had total unilateral paralysis; one had bilateral palsy. Frequent associated anomalies were microtiaatresia, hemifacial microsomia, facial clefts, Moebius syndrome, and congenital conductive sensorineural loss.

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