Clinical characteristics of delayed facial palsy after middle ear surgery- a descriptive study of 40 cases.

IF 2.2 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2025-09-01 Epub Date: 2025-04-12 DOI:10.1007/s00405-025-09384-y

Attila Óvári, Max Bielenberg, Bruno Neuner, Jens Eduard Meyer

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引用次数: 0

Abstract

Purpose: To identify probable triggers of delayed facial palsy (DFP) after middle ear surgery.

Methods: Retrospective single-center chart review of DFP cases between 2010 and 2021.

Results: Forty patients with DFP could be identified after 3,508 middle ear surgeries (1.14%). The occurrence of DFP was after tympanoplasty type 1 1.60%, after tympanoplasty type 3 without mastoidectomy 1.32%, after tympanoplasty type 3 with mastoidectomy 0.36%, and after all tympanomastoid surgery cases 0.35%. The anti-HSV-1 IgM was positive in three cases and borderline in two patients. The anti-VZV IgM was positive in three cases. Beside herpes virus reactivation, facial canal dehiscence (n = 8), bacterial infection, direct nerve microtrauma and intratympanal use of collagenous or oxidized cellulose sponges are presumed pathogenetic factors in our study.

Conclusion: The etiology of DFP is still not conclusively clarified, it has probably a heterogeneous pathogenesis and therefore requires further scientific research. Mastoidectomy may have a protecting effect against DFP. The risk may be reduced by avoiding possible promoting factors but this adverse event cannot be substantially eliminated yet. Nonetheless, we summarize practical considerations for the prevention, diagnosis, and therapy of DFP in the future.

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中耳手术后迟发性面瘫40例临床特点分析

目的：探讨中耳手术后迟发性面瘫（DFP）的可能诱因。方法：对2010 - 2021年DFP病例进行回顾性单中心图表分析。结果：3508例中耳手术后可确诊DFP患者40例（1.14%）。1型鼓室成形术后DFP发生率为1.60%，3型鼓室成形术后不切除乳突1.32%，3型鼓室成形术后切除乳突0.36%，所有鼓室乳突手术后DFP发生率为0.35%。抗hsv -1 IgM阳性3例，临界2例。抗vzv IgM阳性3例。在我们的研究中，除了疱疹病毒再激活外，面神经管开裂（n = 8）、细菌感染、直接神经微损伤和鼓室内使用胶原或氧化纤维素海绵被认为是致病因素。结论：DFP的病因尚不明确，其发病机制可能具有异质性，需要进一步的科学研究。乳突切除术可能对DFP有保护作用。通过避免可能的促进因素可以降低风险，但这一不良事件仍不能完全消除。尽管如此，我们总结了未来预防、诊断和治疗DFP的实际考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.