Clinical analysis of 8 cases of delayed facial paralysis after middle ear surgery

Objective:To investigate the possible causes, prevention, treatment and recovery of delayed facial paralysis after middle ear surgery. Method:A retrospectively analysis of the data of 8 patients with delayed facial paralysis after middle ear surgery under general anesthesia, including one case of tympanoplasty （type Ⅰ） , one case of tympanotomy+tympanoplasty c（type Ⅰ） , one case ofepitympanotomy+reconstruction of attic lateral wall+tympanoplasty （type Ⅱ ）, four cases of canal wall down+tympanoplasty （ type Ⅱ） and one case of canal wall up mastoidectomy. After discovering the facial paralysis, the stuffing in the surgical cavity was released and removed for all patients immediately. Necessary stuffing was replaced by dexamethasone gauze （not press hardl）. Meanwhile, patients took methylprednisolone orally and were intramuscularly injected with mecobalamine. Result:Among eight patients, there were six patients with horizontal exposure of facial nerve and two patients with pyramis exposure of facial nerve. There was one case, five cases and two cases of delayed facial paralysis at five days, one week and two weeks after operation respectively. There were six patients suffering from the facial paralysis of HB Ⅱ grade and two patients suffering from the facial paralysis of HB Ⅲ grade. Four patients recovered four weeks and the remaining four patients returned to normal six weeks after surgery. Conclusion:Delayed facial paralysis is one of complications of the middle ear surgery, and most of patients can recover completely after conservative treatment.