Acute otitis media in pregnancy with unilateral lower motor neuron facial nerve palsy: a case report

Salman Khan; Anuja Bhargava; S. M. Faiz; Saurabh Srivastava; Rajeev K. Gupta; Eshani Dutta; Sanya Siddiqui; Prajwal  Gupta

doi:10.18203/issn.2454-5929.ijohns20252261

Authors

Salman Khan Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Anuja Bhargava Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
S. M. Faiz Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Saurabh Srivastava Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Rajeev K. Gupta Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Eshani Dutta Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Sanya Siddiqui Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India
Prajwal Gupta Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College and Hospital, Lucknow, U. P., India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20252261

Keywords:

Acute otitis media, Corticosteroid, Lower motor neuron, Facial nerve palsy

Abstract

We report the case of a pregnant female of 32-years at 37-weeks of gestational period with four days history of left sided lower motor neuron (LMN) facial palsy with a recent history of bilateral ear pain. She is in her last trimester of pregnancy and expected for a normal vaginal delivery. She had no other ailments and had no history of similar facial palsy in past. The case was managed conservatively with good outcome. Following our experience and review of literature on the case, antibiotic therapy and corticosteroid therapy, with or without myringotomy were found to be the first-line of management. To our knowledge, this is a rare report of LMN facial palsy in association with acute otitis media (AOM) and pregnancy. Some factors involved for LMN palsy in this case could be: compression of horizontal part of facial nerve due to otitis media, increases incidence of Bell’s palsy in pregnancy.

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References

Ellefsen B, Bonding P. Facial palsy in acute otitis media. Clin Otolaryngol. 1996;21(5):393-5. DOI: https://doi.org/10.1046/j.1365-2273.1996.00810.x

House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146-7. DOI: https://doi.org/10.1177/019459988509300202

Hutz MJ, Moore DM, Hotaling AJ. Neurological complications of acute and chronic otitis media Cur Neurol Neurosci Rep. 2018;18(3):11. DOI: https://doi.org/10.1007/s11910-018-0817-7

Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases J Laryngol Otol. 1993;10711:999-1004. DOI: https://doi.org/10.1017/S0022215100125095

Chan CY, Cass SP. Management of facial nerve injury due to temporal bone trauma. Am J Otol. 1999;20(1):96-114.

Bose S, Anjankar A. Incidence of Facial Nerve Palsy in Pregnancy. Cureus. 2022;14(11):e31426. DOI: https://doi.org/10.7759/cureus.31426

Kamitsuka M, Feldman K, Richardson M. Facial paralysis associated with otitis media. Pediatr Infect Dis J. 1985;4(6):682-4. DOI: https://doi.org/10.1097/00006454-198511000-00018

Nager GT, Proctor B. Anatomic variations and anomalies involving the facial canal. Otolaryngol Clin N Am. 1991;24(3):531-53. DOI: https://doi.org/10.1016/S0030-6665(20)31114-2

Joseph EM, Sperling NM. Facial nerve paralysis in acute otitis media: cause and management revisited. Otolaryngol Head Neck Surg. 1998;118(5):694-6. DOI: https://doi.org/10.1177/019459989811800525

Jacobsson M, Nylen O, Tjellstrom A. Acute otitis media and facial palsy in children. Acta Paediatr Scand. 1990;79(1):118-20. DOI: https://doi.org/10.1111/j.1651-2227.1990.tb11344.x

Fukuda T, Sugie H, Masataka I, Kikawada T. Bilateral facial palsy caused by bilateral masked mastoiditis. Pediatr Neurol. 1998;18(4):351-3. DOI: https://doi.org/10.1016/S0887-8994(97)00197-5