Yonsei Med J.  2012 May;53(3):642-648. 10.3349/ymj.2012.53.3.642.

Facial Nerve Paralysis due to Chronic Otitis Media: Prognosis in Restoration of Facial Function after Surgical Intervention

• Kim J
• Jung GH
• Park SY
• Lee WS

• KMID: 1777002
• DOI: http://doi.org/10.3349/ymj.2012.53.3.642

Abstract

PURPOSE
Facial paralysis is an uncommon but significant complication of chronic otitis media (COM). Surgical eradication of the disease is the most viable way to overcome facial paralysis therefrom. In an effort to guide treatment of this rare complication, we analyzed the prognosis of facial function after surgical treatment.
MATERIALS AND METHODS
A total of 3435 patients with COM, who underwent various otologic surgeries throughout a period of 20 years, were analyzed retrospectively. Forty six patients (1.33%) had facial nerve paralysis caused by COM. We analyzed prognostic factors including delay of surgery, the extent of disease, presence or absence of cholesteatoma and the type of surgery affecting surgical outcomes.
RESULTS
Surgical intervention had a good effect on the restoration of facial function in cases of shorter duration of onset of facial paralysis to surgery and cases of sudden onset, without cholesteatoma. No previous ear surgery and healthy bony labyrinth indicated a good postoperative prognosis.
CONCLUSION
COM causing facial paralysis is most frequently due to cholesteatoma and the presence of cholesteatoma decreased the effectiveness of surgical treatment and indicated a poor prognosis after surgery. In our experience, early surgical intervention can be crucial to recovery of facial function. To prevent recurrent cholesteatoma, which leads to local destruction of the facial nerve, complete eradication of the disease in one procedure cannot be overemphasized for the treatment of patients with COM.

Keyword

Facial nerve paralysis; chronic otitis media

MeSH Terms

Adult
Aged
Chronic Disease
Facial Nerve/surgery
Facial Nerve Diseases/*etiology/*surgery
Facial Paralysis/*etiology/*surgery
Female
Humans
Male
Middle Aged
Otitis Media/*complications
Retrospective Studies
Young Adult

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