Diagnosis and treatment of patients with delayed peripheral facial nerve paralysis after tympano-mastoid surgeries
LI Yongqi
CHEN Yubin
YIN Gendi
LI Peng
ZENG Xiangli
Abstract：Objective To report clinical manifestations, diagnosis and treatment of patients with delayed peripheral fa-cial nerve paralysis following tympano-mastoid surgeries. Methods Clinical data including history, physical examination, audiologic findings, CT scan, procedure types, as well as occurrence time, treatment and outcomes of delayed peripheral fa-cial nerve paralysis after tympano-mastoid surgery in 7 cases were retrospectively reviewed. Results Among 664 patients who underwent tympano-mastoid surgeries from March 2010 to December 2014, 7 (1.05%) developed delayed peripheral fa-cial nerve paralysis. Facial paresis started between 5 and 14 days postoperative (mean = 11 days). Facial function was House-Brackmann Grade IV in 4 cases, III in 2 cases and II in 1 case. Bony dehiscence was found in 6 cases at the horizon-tal segment of the facial nerve canal by temporal CT scanning. Three patients reported earache and 3 reported exposure of face to cold air. Herpes virus specific antibodies were tested positive in 3 patients. Patients were treated with antivirals, corti-costeroids, neurotrophic agents and other drugs for 7 to 14 days. All patients showed significant improvement after 10 days of treatment. Facial function returned to normal in 1 month in 6 patients and in 2 months in the other patient. Conclusion De-layed peripheral facial nerve paralysis is one of the rare complications after tympano-mastoid surgery, occurring mainly with-in 10 days postoperative. The etiology is still not clear. Local bacterial or viral infection, packing pressure, and stretching of the chorda tympani during surgery may be possible factors. In this series, facial function showed significant improvement af-ter 10 days treatment with antivirals, corticosteroids and neurotrophic drugs, and recovered to normal within 2 months.
Keywords：Delayed peripheral facial nerve paralysistympano-mastoid surgerycomplicationdiagnosistreatment
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 629-633 )