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Delayed facial palsy after tympanomastoid surgery
1Department of Otolaryngology, University of Texas Medical Branch, Galveston 77555-0521, USA.
The American Journal of Otology
|January 26, 1999
Summary
Delayed facial palsy (DFP) occurred in 1.4% of patients after tympanomastoid surgery. Viral reactivation, particularly varicella zoster virus, is a likely cause of DFP, increasing risk for patients with prior reactivation history.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Disease
Background:
- Delayed facial palsy (DFP) is a rare complication following tympanomastoid surgery.
- The exact incidence and etiology of DFP remain incompletely understood.
- Understanding DFP is crucial for managing patient expectations and optimizing surgical outcomes.
Purpose of the Study:
- To determine the incidence of DFP after tympanomastoid surgery.
- To compare DFP rates across different otologic and neurotologic procedures.
- To explore potential causes of DFP, focusing on viral reactivation.
Main Methods:
- Retrospective case review of 486 patients undergoing tympanomastoid surgery.
- Normal facial nerve function pre-operatively was a selection criterion.
- DFP was defined as facial palsy occurring >72 hours post-surgery.
Main Results:
- Seven out of 486 patients (1.4%) developed DFP.
- Two cases were attributed to postoperative wound infection.
- Five cases were likely caused by viral reactivation, implicating varicella zoster virus.
Conclusions:
- The incidence of DFP appears to increase with greater manipulation of facial nerve sensory branches.
- Viral reactivation is a significant suspected mechanism for DFP.
- Patients with a history of viral reactivation may be at higher risk for developing DFP.