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Effect of surgical intervention on middle-ear cholesteatoma with associated facial paralysis

Published online by Cambridge University Press:  19 December 2016

Y Ozkul ,
M Songu ,
K Onal ,
A Imre ,
S Arslanoglu ,
E Horoz ,
F Bayrak  and
E Pinar
Y Ozkul
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
M Songu*
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
K Onal
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
A Imre
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
S Arslanoglu
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
E Horoz
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
F Bayrak
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
E Pinar
Affiliation:
Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey
*
Address for correspondence: Assoc Prof Murat Songu, Department of Otorhinolaryngology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Turkey Fax: +90 232 243 1530 E-mail: [email protected]
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Abstract

Objectives:

To investigate the presenting symptoms, intra-operative findings and long-term facial nerve function in patients treated for cholesteatoma with associated facial paralysis.

Methods:

Fifteen patients with facial paralysis due to middle-ear cholesteatoma who underwent tympanomastoidectomy surgery from February 2000 to February 2015 were retrospectively reviewed. After removal of the cholesteatoma, a limited area of the fallopian canal, in which facial nerve oedema or redness was evident, was opened. Incision of the epineural sheath for nerve decompression was not performed.

Results:

Pre-operative House–Brackmann grade was grade II in two patients, grade III in four, grade IV in seven, grade V in one and grade VI in one. Facial nerve perineurium damage was observed in two patients with poor prognoses. All patients treated within the first 15 days after paralysis onset showed normal facial function at long-term follow up. Post-operative House–Brackmann grade was grade I in 11 patients, grade II in 1, grade III in 2 and grade VI in 1.

Conclusion:

Early surgical treatment is more likely to give good results, and poor outcomes are observed in patients with facial nerve perineurium damage.

Keywords

Facial ParalysisCholesteatoma, Middle EarPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 2 , February 2017 , pp. 113 - 116
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Choi, JW, Park, YH. Facial nerve paralysis in patients with chronic ear ınfections: surgical outcomes and radiologic analysis. Clin Exp Otorhinolaryngol 2015;8:218–23Google Scholar
2 Prasad, SC, Shin, SH, Russo, A, Di, Trapani G, Sanna, M. Current trends in the management of the complications of chronic otitis media with cholesteatoma. Curr Opin Otolaryngol Head Neck Surg 2013;21:446–54Google Scholar
3 Ozbek, C, Somuk, T, Ciftçi, O, Ozdem, C. Management of facial nerve paralysis in noncholesteatomatous chronic otitis media. B-ENT 2009;5:73–7Google Scholar
4 Sharma, N, Jaiswal, AA, Banerjee, PK, Garg, AK. Complications of chronic suppurative otitis media and their management: a single ınstitution 12 years experience. Indian J Otolaryngol Head Neck Surg 2015;67:353–60Google Scholar
5 Sengupta, A, Anwar, T, Ghosh, D, Basak, B. A study of surgical management of chronic suppurative otitis media with cholesteatoma and its outcome. Indian J Otolaryngol Head Neck Surg 2010;62:171–6Google Scholar
6 Maranhão, AS, Andrade, JS, Godofredo, VR, Matos, RC, Penido, Nde O. Intratemporal complications of otitis media. Braz J Otorhinolaryngol 2013;79:141–9Google Scholar
7 Dubey, SP, Larawin, V. Complications of chronic suppurative otitis media and their management. Laryngoscope 2007;117:264–7Google Scholar
8 Songu, M, Altay, C, Onal, K, Arslanoglu, S, Balci, MK, Ucar, M et al. Correlation of computed tomography, echo-planar diffusion-weighted magnetic resonance imaging and surgical outcomes in middle ear cholesteatoma. Acta Otolaryngol 2015;135:776–80Google Scholar
9 Pinar, E, Sadullahoglu, K, Calli, C, Oncel, S. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg 2008;139:386–90Google Scholar
10 Gülüstan, F, Aslan, H, Songu, M, Başoğlu, MS, Katılmış, H. Relationships between facial canal dehiscence and other intraoperative findings in chronic otitis media with cholesteatoma. Am J Otolaryngol 2014;35:791–5Google Scholar
11 Yetiser, S, Tosun, F, Kazkayasi, M. Facial nerve paralysis due to chronic otitis media. Otol Neurotol 2002;23:580–8Google Scholar
12 Savic, DJ, Djeric, DR. Facial paralysis in chronic suppurative otitis media. Clin Otolaryngol 1989;14:515–17Google Scholar
13 Kim, J, Jung, GH, Park, SY, Lee, WS. Facial nerve paralysis due to chronic otitis media: prognosis in restoration of facial function after surgical intervention. Yonsei Med J 2012;53:642–8Google Scholar
14 Quaranta, N, Cassano, M, Quaranta, A. Facial paralysis associated with cholesteatoma: a review of 13 cases. Otol Neurotol 2007;28:405–7Google Scholar
15 Cawthorne, T. Intratemporal facial palsy. Arch Otolaryngol 1969;90:789–99Google Scholar
16 Ikeda, M, Nakazato, H, Onoda, K, Hirai, R, Kida, A. Facial nerve paralysis caused by middle ear cholesteatoma and effects of surgical intervention. Acta Otolaryngol 2006;126:95–100 Google Scholar
17 Altuntas, A, Unal, A, Aslan, A, Ozcan, M, Kurkcuoglu, S, Nalca, Y. Facial nerve paralysis in chronic suppurative otitis media: Ankara Numune Hospital experience. Auris Nasus Larynx 1998;25:169–72Google Scholar