[Facial nerve paralysis secondary to acute otitis media]

Abstract

Objects: To discuss clinical presentation and therapeutic approaches of facial paralysis in acute otitis media.

Methods: We present five cases of facial palsy in children with acute otitis media managed in our ENT department during a period of 12 years (2001-2012).

Results: The mean age was 14.2 years; sex ratio was 0.66. All patients presented with a facial asymmetry, but only 3 of them had otalgia before the onset of facial asymmetry. The facial palsy delay was 3.3 days. The ear examination showed that the tympanic membrane was congestive in 4 patients, associated with a bulging in 2 patients, and a small perforation in one patient. Our patients presented grade III to IV initial facial palsy according to House and Brackmann staging. Computed tomography scan revealed a dehiscence of the bony facial canal in one patient. Antibiotic therapy associated with intravenous corticosteroids was administered in all patients. All patients underwent a facial kinesis therapy. A progressive improvement of facial palsy was observed in 4 patients and complete recovery of facial function in one case.

Discussion: Conservative treatment associating intravenous antibiotic and corticosteroids with or without myringotomy is the standard approach.