[Facial paralysis after non-otologic surgery under general anesthesia]

Area of Science:

• Anesthesiology
• Neurology

Background:

• Peripheral facial palsy is an uncommon complication following non-otological surgery under general anesthesia.
• It is typically attributed to endotracheal intubation-related nerve damage, especially in patients with anatomical variations.

Observation:

• Three cases of peripheral facial palsy occurred post-abdominal surgery.
• All patients received nitrous oxide as part of their anesthesia.
• One patient underwent tracheostomy, and all presented with endocranial facial symptoms and prior surgical history.

Findings:

• The co-occurrence of nitrous oxide use and facial palsy suggests a potential link.
• Nitrous oxide can elevate middle ear pressure, leading to focal facial nerve compression.
• This mechanism offers an alternative or contributing factor to facial palsy, beyond intubation trauma.

Implications:

• These findings broaden the understanding of facial palsy pathophysiology after surgery.
• Anesthesiologists should consider nitrous oxide's role in middle ear pressure changes.
• Further investigation into anesthetic agents and nerve injury mechanisms is warranted.