Delayed facial paralysis after stapedectomy and discussion on its mechanism

doi:10.3321/j.issn:1673-8225.2004.20.010

Abstract：BACKGROUND: A facial palsy appears only in rare cases a few days after uneventful stapedectomy, which has unclear pathogenesis.OBJECTIVE: To study the incidence, pathogenesis and treatment of delayed facial palsy after stapedectomy.DESIGN: A non-randomized controlled study was conducted based on diagnosis.SETTING and PARTICIPANTS: The study was completed in the Department of Otorhinolaryngology, the Affiliated Drum Tower Hospital of Nanjing University Medical School. Subjects were 3 female cases aged 34 -48 years with delayed facial palsy.METHODS: Three delayed facial palsy patients in 332 stapedectomy patients were retrospectively reviewed.MAIN OUTCOME MEASURES: House-Brackmann facial nerve grading system.RESULTS: Delayed facial palsy occurred from 5 to 6 days after stapedectomy in three cases, who all suffered from uncompleted peripheral paralysis. Anti-herpes simplex antibody titers were elevated in one patient who received the test. A high dose of hormone, antiviral drugs and vitamins were effective, which were also combined with acupuncture treatment. All three cases recovered.CONCLUSION: The probable pathogenesis of delayed facial palsy after uneventful stapedectomy might relate with the reactivation of dormant herpes simplex virus except for the dehiscence in bony facial nerve canal.