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Delayed facial nerve paralysis post middle ear surgery: herpes simplex virus activation

A De Stefano1, G Neri, G Kulamarva

  • 1Dipartimento di Scienze Chirurgiche, Sperimentali e Cliniche, sezione di Otorinolaringoiatria, Università degli Studi G. d'Annunzio Chieti-Pescara, Italy. dr.adestefano@gmail.com

B-ENT
|May 22, 2009
PubMed
Abstract

Insights

Delayed facial nerve paralysis after middle ear surgery can be caused by herpes simplex virus reactivation. Suspect viral causes for palsy appearing over 72 hours post-procedure without infection signs.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Virology

Background:

  • Facial nerve paralysis post middle ear surgery is a significant concern for otologic surgeons.
  • Typically, paralysis results from surgical trauma or local anesthetic, with onset usually within 72 hours.

Observation:

  • This case details facial nerve paralysis occurring 11 days after a canal wall-down mastoidectomy.
  • The patient presented with delayed palsy without signs of infection.

Findings:

  • Viral screening identified Herpes Virus type 1 as the cause of the delayed facial paralysis.
  • This confirms a viral etiology for the post-operative nerve dysfunction.

Implications:

  • Delayed facial nerve palsy (>72 hours) after uneventful middle ear surgery warrants consideration of viral reactivation, specifically herpes simplex virus.
  • Early diagnosis and management of viral-induced facial nerve palsy can improve patient outcomes.

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