Opioid Prescriptions and Risk of Complications After Tonsillectomy in Children—Reply

Abstract

This case is the first report in the literature, to our knowledge, of permanent facial palsy after aural irrigation. In this instance, it was also associated with permanent hearing loss. It is our opinion that the pressure of aural irrigation caused traumatic perforation of the tympanic membrane, and subsequent trauma to the facial nerve and inner ear (through pressure to the oval or round window). It is possible that this patient had congenital dehiscence of the facial nerve, making injury more probable, and it is also possible that superadded infection contributed to injury.There is still debate about the role of irrigation, ceruminolytic agents, and instrumentation in the removal of cerumen, and the recent American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines recognized a lack of comparative studies in the current literature to guide best practice. 6 Conclusions | Whereas serious complications from treatment of cerumen are rare, we think it is nevertheless important to document such cases because they contribute to the debate on the optimum method for treatment. The patient presented herein has had serious, permanent, and life-changing consequences with facial palsy and hearing loss resulting from aural irrigation. This is a relevant consideration to those using or wishing to promote this method.