Delayed Facial Nerve Paralysis after Tympanomastoid Surgery: The Potentiality of Fungal Infection and Treatment

Abstract

Received December 24, 2010 Revised April 5, 2011 Accepted April 6, 2011 Address for correspondence Hyong Ho Cho, MD, PhD Department of OtolaryngologyHead and Neck Surgery, Chonnam National University Medical School, 671 Jebong-ro, Dong-gu, Gwangju 501-746, Korea Tel +82-62-220-6772 Fax +82-62-228-7743 E-mail victocho@hanmail.net Background and ObjectivesZZThe purpose of this study was to assess the clinical courses and clinical outcomes of delayed facial nerve paralysis (DFNP) after middle ear and mastoid surgery. Subjects and MethodZZIn our hospital, postoperative DFNP occurred in 13 cases among the patients who underwent ear surgery from December 2000 to February 2010. During the same period, another 4 cases with postoperative DFNP were diagnosed at a local clinic. We assessed the degree of DFNP by using House-Brackmann grade (HBG) and separated 8 patients in grade II, 6 patients in grade III and 3 patients in Grade IV. Among 17 patients, DFNP occurred after open cavity mastoidectomy in 11 cases and after closed cavity mastoidectomy in the rest of 6 cases. ResultsZZAmong 17 postoperative DFNP, fungal infections were found in three patients. Patients for whom antifungal agent was relatively delayed in application, their condition did not improved. ConclusionZZAfter treatment, most of patients recovered within 1 month and there were no other associated infection during hospitalization. We suggest that antifungal agents should be used as soon as possible when patients complain about DFNP following open cavity mastoidectomy. Korean J Otorhinolaryngol-Head Neck Surg 2011;54:324-8