No abstract

Background: Facial nerve palsy is a common intra-temporal complication of untreated chronic suppurative otitis media (CSOM) causing erosion of the fallopian canal and its pressure effects leading to facial weakness. There is a less favorable outcome in patients of CSOM with diabetes as they are more prone to neural degeneration. In such patients, early surgical decompression of the facial nerve helps in resolving facial palsy to some extent. In our study of 22 patients, we analyzed the prognosis and advantage of doing early surgical facial nerve decompression along with modified radical mastoidectomy in patients of unsafe CSOM with diabetes mellitus. Materials and Methods: We present a retrospective study of 22 patients with a squamosal type of CSOM with diabetes mellitus who came to the outpatient department, from June 2019 to March 2021, with complaints of ear discharge and facial palsy grades 3–5, in whom we did early surgical facial nerve decompression along with modified radical mastoidectomy. We observed the incidence of facial palsy and recovery after facial nerve decompression with limited use of steroids in patients with diabetes mellitus. Results: In our retrospective study of 22 patients with squamosal type of CSOM with diabetes mellitus with complaints of facial palsy, 10 were males and 12 were females. Patients were assessed clinically using House–Brackmann grading: 55% are of grade III, 31% are of grade IV, and 14% are of grade V. About 82% of the patients from our study had lesions at the tympanic segment, 9% patients had lesions at the vertical segment, 4.5% patients had lesion at the first genu, and 4.5% patients had lesion at the second genu. In our study, 95% of the patients from the study improved with early facial nerve decompression along with modified radical mastoidectomy, 55% of the patients improved to grade I, 36% of the patients improved to grade II, and 9% of the patients improved to grade III. Conclusion: In squamosal-type CSOM patients with facial palsy, early facial nerve decompression along with modified radical mastoidectomy within 12 weeks of development of facial palsy provides better results than just modified radical mastoidectomy as it increases recovery rate and reduces the need for post-operative steroids which is an advantage in diabetics.