Facial Nerve Paralysis Due to Middle Ear Cholesteatoma

Facial nerve paralysis associated with middle ear cholesteatoma, although well known, is only occasionally encountered and its clinical features and management have been evaluated in only a few studies. We studied its clinical features associated with facial paralysis. Subjects numbered 20 [15 males and 5 females] from 3-82 years old (mean: 42.6 years) with facial nerve paralysis due to middle ear cholesteatoma undergoing surgery between 1990 and 2008. After cholesteatoma lesion resection, a limited area of the fallopian canal in which facial nerve edema or redness was evident was opened, although the epineural sheath was not incised for nerve decompression. Initial paralysis was incomplete in 13 (65%). Paralysis onset was sudden in 16 (80%). The facial paralysis outcome was favorable in 14 (70%). Facial paralysis outcome was largely favorably, although poor outcomes were observed in cases with petrosal cholesteatoma and in those undergoing surgery ≥2 months after paralysis onset.