Facial Nerve Palsy in Malignant Otitis Externa Hospitalizations: Outcomes and Risk Factors

To provide a description of the occurrence of facial nerve palsy in hospitalizations for malignant otitis externa and to compare the demographic characteristics, hospital traits, comorbidities, and outcomes between patients with and without palsy.

Retrospective cross-sectional database study.

2016 to 2022 National Inpatient Sample (NIS).

Hospitalizations for malignant otitis externa were identified using ICD-10 diagnosis codes, and facial nerve palsy was identified using secondary diagnosis codes. Weighted discharge level rates of facial nerve palsy were calculated, and demographics, comorbidities, and outcomes were compared between patients with and without facial nerve palsy.

695 (12.4%) of 5,585 MOE inpatient stays involved facial nerve palsy. Stays involving palsy were significantly more likely to occur in older patients (71.16 ± 13.4 years vs 56.07 ± 21.1 years, P < .001), in men (70.7% vs 55.6%, P < .001), have a higher number of diagnoses (17.51 vs 13.2, P < .001) and chronic conditions (7.91 vs 7.01, P = .001) than stays without palsy. Diabetes with chronic complications, complicated and uncomplicated hypertension, and peripheral vascular disease were all significantly more common within the palsy group. Hospitalizations with a palsy diagnosis were associated with longer hospital stays, (7.80 ± 7.5 days vs 5.21 ± 6.8 days, P < .001), with smaller proportions of stays resulting in routine discharge.

One in eight US inpatient stays for MOE involved facial nerve palsy, which was associated with older age, advanced comorbidities, longer hospitalizations, and increased care needs following discharge. These findings support the association of facial nerve palsy with heightened comorbidity burden.