Facial Paralysis with Ear Disease
Facial nerve dysfunction can be seen in patients who suffer from acute and chronic ear infections (otitis media). There are a number of ways that the facial nerve can be affected, and usually the time course of onset and the duration of the facial nerve dysfunction are indicators of the state of the nerve and the likelihood of full recovery.
Facial paralysis that occurs suddenly during an acute ear infection implies inflammation of the nerve, leading to a blockage of neural impulses (neurapraxia). This tends to occur in infants and young children, because the bony canal surrounding the nerve is not as insulated from the middle ear space as it is in adults. Ordinarily, prompt treatment of the infection, that sometimes includes putting a hole in the ear drum to remove the infected contents, leads to recovery of the nerve.
Facial paralysis or paresis (partial paralysis) immediately following ear surgery can be related to one of several things.
Sudden facial paralysis in the setting of chronic ear disease suggests
damage caused by expanding chronic infection. Pressure on the nerve can
occur if the disease affects and wears away bone, as is seen with cholesteatoma.
When sudden facial paralysis occurs in the face of known chronic ear disease,
prompt surgical exploration with evacuation of disease and nerve decompression
usually results in good recovery of function.