Delayed Facial Nerve Palsy following Uneventful Stapedectomy

Marioni, Gino; Filippis, Cosimo de; Gaio, E.; Staffieri, Alberto

doi:10.1159/000049269

Cited by 8 publications

(1 citation statement)

References 21 publications

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“…Among the various complications, facial palsy, or weakness is the most concerning. Some studies reported incidence rates ranging from 0.07% to 1%, 18 whereas another publication cited an incidence rate of 0.51%. 9 Although none of the cases included herein developed total facial palsy, two patients (1.88%) experienced grade II facial weakness following surgery.…”

Section: Discussionmentioning

confidence: 99%

Modified stapes surgery for otosclerosis: An evaluation of auditory results and postoperative complications

Chang,

Chau,

Liu

et al. 2024

Journal of the Chinese Medical Association

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Background: The senior author Shiao, had introduced a modified version of the traditional stapes surgery, called minimally traumatic stapes surgery (MTSS), and explored its effectiveness in reducing postoperative vertigo. However, MTSS exhibited no significant breakthrough in terms of audiometric results. Building upon the original MTSS through slight modifications and the use of the Medtronic Big Easy® Piston as the prosthesis, this study evaluates a refined version of the original MTSS technique. In particular, this research sought to investigate the impact of this refined approach on hearing outcomes and postoperative complications among patients diagnosed with otosclerosis. Methods: This research comprehensively examined the medical records of individuals diagnosed with otosclerosis who underwent MTSS. The postoperative outcomes assessed encompassed hearing outcomes and the occurrence of any new complications. Results: Overall, 95 patients diagnosed with otosclerosis (comprising 106 affected ears) underwent MTSS. Significant improvements in both the average air conduction threshold (40 ± 16.82 dB after vs 60 ± 14.56 dB before surgery; p < 0.0001) and average air–bone gap (11.99 ± 7.24 dB after vs 29.65 ± 9.47 dB before surgery; p = 0.003) were observed after the surgery. Conversely, no significant change in the average bone conduction threshold was observed after the procedure (28 ± 13.81 dB after vs 29 ± 12.31 dB before surgery; p = 0.149). Among the 106 affected ears, 102 showed postoperative air–bone gap measurements <20 dB, indicating an impressive 96.2% overall hearing improvement. Notably, only a few postoperative complications were observed, including vertigo, chorda tympani injury, facial weakness, and a slight hearing deterioration. Conclusion: The refined MTSS technique promoted significant postoperative hearing improvements with minimal complications. This approach showed potential for addressing the surgical challenges in Asian patients with otosclerosis, emphasizing the importance of further research on this advanced procedural method.

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Section: Discussionmentioning

confidence: 99%

Modified stapes surgery for otosclerosis: An evaluation of auditory results and postoperative complications

Chang,

Chau,

Liu

et al. 2024

Journal of the Chinese Medical Association

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Post‐traumatic Delayed Facial Nerve Palsy: Report of 2 Cases and Systematic Review

Daloiso,

Franz,

Mondello

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveDelayed facial nerve palsy (dFNP) secondary to head injury is definitely uncommon. Although the mechanism of immediate facial nerve paralysis is well‐studied, its delayed presentation remains debated. Given the dearth of available information, we reported herein our experience with 2 cases of posttraumatic dFNP. This systematic review aimed to evaluate all available information on dFNP and to assess treatment outcome also comparing conservatively and surgically approaches.Data SourcesPubmed, Scopus, and Web of Science databases were systematically screened.Review MethodsThe protocol of this investigation was registered on PROSPERO in April 2023 and the systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses statement.ResultsBoth patients in the case studies showed a complete recovery within 2 to 3 months after the head trauma. One of them still reported a subjective taste alteration at last control. After the application of the inclusion‐exclusion criteria, 9 manuscripts with adequate relevance to this topic were included in the systematic review. The study population consisted of 1971 patients with a diagnosis of posttraumatic facial nerve palsy, of which 128 with a dFNP.ConclusionsdFNP due to head trauma is a rarely encountered clinical entity, and optimal treatment still remains to be elucidated. Based on the reported data, it seems rational to propose a conservative approach for dFNP with steroid administration as a first line in most cases, indicating surgery in severe and/or refractory cases.

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