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May 1989

Facial Nerve Palsy Following Tympanomastoid Surgery

Author Affiliations

London, England

Arch Otolaryngol Head Neck Surg. 1989;115(5):635. doi:10.1001/archotol.1989.01860290093027

To the Editor.—The facial nerve is at risk to some extent in all forms of middle ear or mastoid surgery. These risks can be increased because of congenital anatomic abnormalities, previous surgery, operator inexperience, or where chronic disease has caused the nerve to become unusually exposed.

In cases where a total facial nerve paresis has been noted immediately following surgery, it has been accepted practice to undertake reexploration of the operative field in order to either decompress the nerve or to undertake grafting if severe damage has taken place.1,2

In two recent cases, once following a myringoplasty and once following a mastoidectomy, the patients were noted to have complete lower motoneuron lesions of the facial nerve on the side that underwent the operation. In both cases, full restoration of the facial nerve junction occurred within 70 minutes of the initial observation. Such severe initial lesions, which recovered so

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