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KMID : 0361020000430101057
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Korean Journal of Otolaryngology - Head and Neck Surgery
2000 Volume.43 No. 10 p.1057 ~ p.1061
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Clinical Analysis of Delayed Facial Nerve Palsy after Middle Ear Surgery
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장선오/Sun O Chang
황찬호/구자원/오승준/이상준/성원진/정하원/유원석/김종선/Chan Ho Hwang/Ja-Won Koo/Seung Jun Oh/Sang Joon Lee/Weon-Jin Seong/Ha won Jung/Won Seok Yu/Chong-Sun KIm
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Abstract
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Background and Objectives : Delayed facial nerve palsy(DENP) following a middle ear surgery is
an uncommon event, and is defined to develop 48 or 72 hours after surgery. The pathogenesis of
DENP is not known clearly, but it is presumed to inflammation, neuronal edema or reactivation of
herpes virus. The purposes of this study were to provide the clinical aspect of DENP after middle
ear surgery and to discuss the prognostic factors and treatment plan.
Materials and Methods : From January 1985 to August 1999, in the course of over 5.670 middle
ear surgeries, we experienced 12 ipsilateral delayed facial nerve palsies. We analyzed the course of
DFNP according to several clinical factors retrospectively. Degree of facial palsy was evaluated
with the House-Brackmann grade(HBG).
Results : DFNP was developed from 3 day to 14 day after middle ear surgery. The initial degree
of facial palsy was House Brackmann grade(HBG)Ⅱ in HBG Ⅲ in 4, and HBGⅣ in 2 patients.
All patients were treated with steroid and volume expander. The final recovery were HBGⅠ in 11
of the twelve patients. Remaining one patient was found to be HBGⅡ after a 5-year follow up. In
the group who recovered within 1 month, the initial HBG were Ⅱ orⅢ.
Conclusion : We obtained satisfactory results with steroid therapy in most patients. The courses
of DFNP after middle ear surgery are favorable. The better initial HBG and HBG at 2 weeks are,
the earlier recovery can be expected.
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