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Updated: Apr 30, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
[Facial nerve paralysis secondary to acute otitis media]
Houda Chahed1, Afef Dhaouadi1, Azza Mediouni1
1Université de Tunis El Manar, faculté de médecine de Tunis, hôpital de la Rabta, service ORL et chirurgie maxillofaciale, 1007 Tunis, Tunisie.
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.
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