Otogenic Facial Paralysis

Chronic suppurative otitis media is a destructive process that can involve the facial nerve and may result in an impairment of its function. In the preantibiotic era, facial paralysis occurred in 2.3% of patients with chronic suppurative otitis media. Although the frequency of otogenic facial paralysis has decreased since the introduction of antibiotics, it still occurs in about 1% of patients with chronic otitis media.

The purpose of the present paper is to report the results of our study of 104 patients with a facial paralysis due to chronic suppurative otitis media. During the 10-year period from 1996 to 2005, about 3800 patients at our clinic had surgery for chronic otitis media and 104 had a preoperative facial paralysis. Otogenic facial paralysis was clinically complete in 66% and incomplete in 34% of the patients. Cholesteatoma was found in 80%. Facial paralysis was more common as an isolated lesion not associated with other complications. When present, bone destruction of the facial canal was most frequently seen in its tympanic portion. The occurrence of facial paralysis did not depend on the extent of destruction of the facial canal. Facial nerve function recovered in 70%, recovered partially in 24%, and failed in 6% of the patients. The degree of recovery of facial nerve function did not depend on the findings at surgery. In some cases the facial canal was extensively destroyed with pronounced pathological process around the exposed nerve, but after decompression, the facial function recovered completely.