Etiological diversity of otogenic facial nerve palsy in children – a case series and literature review

Abstract

Facial nerve palsy in children causes a significant impact on the quality of life. Infectious cause such as otitis media is the second most common etiology for facial nerve palsy in children. We describe the presentation, management and outcomes of four such children who presented to our institution with facial nerve palsy secondary to acute or chronic otitis media. Case one was unique due to the underlying immunodeficiency and severe grade of facial nerve palsy. Case three was managed conservatively, hence emphasising that early treatment can completely curb the need for a surgical intervention. Cases two and four, with grade two to three facial nerve palsy showed good clinical improvement after surgery. Timely reference to otolaryngology by pediatric peers can prevent the onset or worsening of complications secondary to otitis media such as facial nerve palsy. Recurrent episodes of otitis media should raise a high degree of suspicion of immunodeficient states, which will require a multi-disciplinary treatment.