Int. Adv. Otol. 2009; 5(3); 371-376

Evaluation and treatment of facial palsy in acute versus chronic otitis media - Could prognosis be altered?
Haim Gavriel, Alex Kessler, Ronen Perez, Ephraim Eviatar

Department of Otolaryngology, Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin Israel, haim.ga@012.net.il

Objective: Otologic facial palsy (FP) is a well known complication of otitis media, both acute and chronic. The purpose of this
study was to compare treatment strategies and level of neural and otologic recovery in cases of FP in acute otitis media (AOM)
versus chronic otitis media (COM) during a 7-year period.

Materials and Methods: A consecutive cohort of 20 patients with otologic FP between the years 1994 to 2000 was evaluated
retrospectively and various parameters were examined.

Results: Symptoms were reported only by COM patients and one acute otitis media adult. Otologic examination was pathologic
in all cases, average primary House Brackmann score was 4 in both groups and cholesteatoma was identified in three
COM adults. Conservative treatment was initiated in all cases with decompression performed in four COM patients. Complete
neurologic healing was observed in 30%, with better but not significant results in AOM cases. Neurologic outcome was lower
than previously reported especially in the AOM group.

Conclusion: No correlation was found between neurologic outcome and antibiotic treatment decision, bacteriologic studies or
surgical treatment.