Facial Nerve Paralysis as A Complication of Acute Otitis Media

Abstract

Background: Facial nerve paralysis is not a very frequent association with acute otitis media (AOM). The pathophysiology and treatment of this condition still under debate.Aim of the Work: to review the treatment strategies and extent of recovery in patients with facial nerve paralysis after AOM. Patients and Methods:The study was a retrospective study. Authors reviewed a total of 4710 cases of AOM seen during the period form 2010 to 2020. Fourty cases developed facial nerve paralysis. All were reviewed for epidemiological data and clinical assessment. Facial palsy was graded by House-Brackmann scale. All patients were treated with antibiotics combined with oral or intravenous corticosteroids. Myringotomy with or without application of a ventilation and mastoidectomy without decompression of the facial nerve were performed in selected cases.Result: Normal facial function was resumed to normal in all patients. The paralysis was mainly of acute onset (90.0%) and otorrhea reported among 12.5%. The initial paralysis grade was mainly grade IV (41.3%) followed by grade III (26.3%). The topography was mainly infrageniculate (86.3%). A collected material for bacteriology was reported for 40.0%, and 53.1% of them had negative culture. The most common detected organism was staphylococcus aureus (18.8%). Myringotomy was done for 7.5%, aspiration for 10.0% and Mastoidectomy for 10.0%. The overall outcome was good among 90.0% and bad among 10.0%. The duration for complete cure in cases with good outcome not exceeded 3 months. Only lower initial grade on House-Brackmann scale and infrageniculate topography were associated with favorable outcome. Conclusion:The management of facial nerve paralysis due to acute otitis media could be conservative by antibiotics with corticosteroids.