Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (5): 1-5.doi: 10.6040/j.issn.1673-3770.0.2022.209

   

An analysis of the clinical characteristics of delayed facial paralysis following middle ear surgery

WEN Liting1,2, LI Xu3, GAO Wei4, HU Tianyong1, ZENG Xianhai1, ZHA Dingjun2   

  1. 1. Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key laboratory of E.N.T, Institute of E.N.T, Shenzhen, 518172, Guangdong, China;
    2. Department of Otorhinlaryngology & Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, Shaanxi, China;
    3. Department of Otolaryngology, the 984 Hospital of the People's Liberation Army, Beijing 100094, China;
    4. Department of Otorhinlaryngology & Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an 710038, Shaanxi, China
  • Published:2022-09-20

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Abstract: Objective To explore the causes, treatments, and outcomes of delayed facial paralysis(DFP)after different types of middle ear surgery. Methods A retrospective study was done on the clinical data of 1 124 cases experienced middle ear surgery from January 2017 to December 2018, including onset, risk factors, treatment and rehabilitation of DFP. Results Among the 1 124 patients who underwent middle ear surgery, 17(1.51%)presented DFP 3-20 days after surgery, with an average incidence at 10.00±4.11 days. The incidence of DFP after type Ⅰ tympanoplasty, type Ⅱ tympanoplasty, and tympanoplasty with mastoidectomy of the canal wall down were 2.30%, 1.62%, and 0.95%, respectively, and the differences were not statistically significant. The incidence of DFP in 776 patients with intact facial canal and 348 with dehiscent facial canal were 1.55% and 1.44%, respectively, and this difference also was not statistically significant. In addition, postoperative infection with Pseudomonas aeruginosa occurred in one of the patients with DFP who was later treated with a great auricular nerve graft and facial nerve anastomosis. The patient's condition improved to grade III a year after surgery. The remaining 16 patients were treated with steroids as conservative management, and their conditions were fully restored after 0.5-3 months. Conclusion The possible cause of DFP following middle ear surgery has nothing to do with surgical approaches and facial canal dehiscence. Notably, conservative management resulted in good outcomes.

Key words: Delayed facial paralysis, Middle ear, Tympanoplasty, Tympanoplasty with mastoidectomy of cannal wall down, Facial nerve, Anastomosis

CLC Number: 

  • R764.2
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