Facial Palsy and Sensorineural Hearing Loss without Typical Clinical Picture of Acute or Chronic Otitis Media

Background and Aim: Facial palsy is a well-known complication of acute and chronic otitis media. We present a case of facial nerve paralysis following otitis media without significant pain or history of chronic otitis media.

Case Report: A 50-year-old patient presented to our department with right facial nerve paresis, bilateral hearing loss (progressive during the last 2 months), and a “blocking” feeling with mild pain in both ears. At presentation, he showed a House-Brackmann IV right facial nerve paralysis. On clinical examination, both ears had the clinical picture of otitis media with effusion. The CT scan revealed a picture of fluid and soft tissue in both sides. Pure tone audiometry showed a severe mixed type hearing loss in the right ear and a moderate mixed hearing loss in the left ear. He was treated with IV antibiotics and IV corticosteroids for 14 days. Myringotomy revealed a whitish fluid and grommets were inserted bilaterally. The patient's hearing improved in the left ear and the small gap in the right ear was closed (the severe sensorineural component remained). The facial palsy recovered within 1 month following discharge.

Conclusion: Facial palsy may, rarely, complicate otitis media with effusion.