Clin Exp Otorhinolaryngol.  2015 Sep;8(3):218-223. 10.3342/ceo.2015.8.3.218.

Facial Nerve Paralysis in Patients With Chronic Ear Infections: Surgical Outcomes and Radiologic Analysis

• Choi JW
• Park YH

• KMID: 2117515
• DOI: http://doi.org/10.3342/ceo.2015.8.3.218

Abstract

OBJECTIVES
The purpose of this study was to investigate the clinical features, radiologic findings, and treatment outcomes in patients of facial nerve paralysis with chronic ear infections. And we also aimed to evaluate for radiologic sensitivities on facial canal, labyrinth and cranial fossa dehiscences in middle ear cholesteatomas.
METHODS
A total of 13 patients were enrolled in this study. Medical records were retrospectively reviewed for clinical features, radiologic findings, surgical findings, and recovery course. In addition, retrospective review of temporal bone computed tomography (CT) and operative records in 254 middle ear cholesteatoma patients were also performed.
RESULTS
Of the 13 patients, eight had cholesteatomas in the middle ear, while two patients exhibited external auditory canal cholesteatomas. Chronic suppurative otitis media, petrous apex cholesteatoma and tuberculous otitis media were also observed in some patients. The prevalence of facial paralysis in middle ear cholesteatoma patients was 3.5%. The most common involved site of the facial nerve was the tympanic segment. Labyrinthine fistulas and destruction of cranial bases were more frequently observed in facial paralysis patients than nonfacial paralysis patients. The radiologic sensitivity for facial canal dehiscence was 91%. The surgical outcomes for facial paralysis were relatively satisfactory in all patients except in two patients who had petrous apex cholesteatoma and requiring conservative management.
CONCLUSION
Facial paralyses associated with chronic ear infections were observed in more advanced lesions and the surgical outcomes for facial paralysis were relatively satisfactory. Facial canal dehiscences can be anticipated preoperatively with high resolution CTs.

Keyword

Facial Paralysis; Ear; Infection; Cholesteatoma

MeSH Terms

Cholesteatoma
Cholesteatoma, Middle Ear
Ear Canal
Ear*
Ear, Inner
Ear, Middle
Facial Nerve*
Facial Paralysis
Fistula
Humans
Medical Records
Otitis Media
Otitis Media, Suppurative
Paralysis*
Prevalence
Retrospective Studies
Temporal Bone

Figure

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  Fig. 1 Preoperative temporal bone computed tomography of patient No. 8 showing a fallopian canal defect in the mastoid segment of the facial nerve (arrow).

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  Fig. 2 Computed tomography of patient No. 2 showing all semicircular canals and vestibular destructions. Note the absence of the facial nerve in the tympanic and mastoid segment with a combined posterior cranial base defect (arrows).

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