Etiology and therapy of delayed facial paralysis after middle ear surgery

Eckermann, Jonas; Meyer, Jens E.; Guenzel, Thomas

doi:10.1007/s00405-020-05825-y

Cited by 9 publications

(12 citation statements)

References 39 publications

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“…Postoperative neural edema increased nerve dysfunction by compressing the nerve, which peaked on the fth postoperative day and completely resolved on the 14th postoperative day. Reportedly, one of the causes of delayed facial paralysis after middle ear surgery is neural edema in the facial nerve, which usually occurs on the second postoperative day [22]. In addition, reperfusion damage may occur in the nerve, and the Haber-Weiss reaction may be observed in the region after ischemia.…”

Section: Discussionmentioning

confidence: 99%

Does mandibular osteotomy affect the infraorbital nerve? a prospective study

Ak,

Özel,

Süzen

et al. 2023

Clin Oral Invest

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The aim of this study was to evaluate the sensory function of the infraorbital nerve after orthognathic surgery (OS) . Materials and methodsPatients who underwent Le Fort I osteotomy with or without BSSO for dentofacial deformity treatment were studied. Two groups were created according to whether BSSO was performed. Class A tests were performed to determine the degree of peripheral nerve damage. The Class B test was performed if decreased sensation was detected in at least one of these tests. A Class C test was performed if abnormal sensation was detected. ResultsTwenty-eight patients (n = 56) who underwent OS were included in this prospective study. Of the patients, 57.1% were female, 42.9% were male, and the mean age was 24.6 (± 3.8). Seven patients were in group 1 (n = 14), and 21 patients were in group 2 (n = 42). In both groups, there were statistically signi cant differences between T1 and T2 (p < 0.001), and the mean NSD score at T2 was higher than that at T1. The mean NSD score in the single jaw group was higher than that in the double jaw group at all time points. ConclusionsBimaxillary surgeries had a negative effect on the somatosensory changes that developed in the early period. The upper lip's somatosensorial recovery was faster than IOR and single jaw recovery was faster than double jaw.

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Section: Discussionmentioning

confidence: 99%

Does mandibular osteotomy affect the infraorbital nerve? a prospective study

Ak,

Özel,

Süzen

et al. 2023

Clin Oral Invest

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“…They suggested that drill heat is a more likely cause of immediate palsy. 8,14 Other suggested etiologies of DFP are related to direct pressure on the tympanic segment of the facial nerve from middle ear packing and local effects of blood breakdown products leading to vasospasm along the tympanic segment. Theoretically, both of these would be at higher risk with a dehiscent tympanic segment.…”

Section: Discussionmentioning

confidence: 99%

“…2,[5][6][7] Most patients are treated with steroids and the prognosis for full recovery is excellent. 8 After middle ear surgery, the overall incidence of DFP is 0.65% based on a recent meta-analysis; however, the vast majority of reported cases are derived from the adult literature. 2 Reports of pediatric DFP are relatively under-represented in previous cohorts.…”

Section: Introductionmentioning

confidence: 99%

Effects of Age on Delayed Facial Palsy After Otologic Surgery: A Systematic Review and Meta-Analysis

Lovin

Sweeney

Chapel

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: To report 4 cases of delayed facial palsy (DFP) after pediatric middle ear (ME) surgery and systematically review and analyze the associated literature to evaluate the effects of age on DFP etiology, management, and prognosis. Methods: Systematic review of PubMed, Cochrane Library, and Embase for articles related to DFP after cochlear implantation (CI) was performed. These articles were assessed for level of evidence, methodological limitations, and number of cases. Meta-analysis was performed to assess the effects of age on DFP incidence. Furthermore, a comprehensive list of all pediatric DFP cases after otologic surgery was assembled through a multi-institutional retrospective review and systematic review of the literature. Results: Twenty-nine articles fit the criteria for inclusion in the meta-analysis. The incidence of DFP after CI was 0.23% and 1.01% for pediatric and adult cases, respectively. This difference was statistically significant ( P < .001, odds ratio 4.36). Twenty-three cases, adding to the 4 presented herein, were suitable for a comprehensive list. The mean age was 6.9 years. Average postoperative day of paresis onset was 5.4, with an average maximum House–Brackmann grade of 3.5. All patients obtained full facial recovery after an average of 23.5 days. Conclusions: The systematic review demonstrates that DFP after pediatric CI is rare and occurs at a significantly lower rate than in adults, further supporting the viral reactivation hypothesis of DFP. The prognosis for pediatric DFP after otologic surgery is excellent, with a high rate of full recovery in a short time frame. However, steroid administration can be considered. Level of evidence: IIa

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“…Delayed facial nerve palsy (DFNP) is most commonly described in the setting of vestibular schwannoma resection, middle ear surgery, and trauma. 3 Delayed facial nerve palsy is graded on the House–Brackmann scale that quantifies facial nerve function on a 6-point scale ranging from normal function to no function at all. Typically, this is a temporary palsy that resolves over a one-month period with little to no sequelae.…”

Section: Discussionmentioning

confidence: 99%