Facial nerve paralysis in malignant otitis externa: comparison of the clinical and paraclinical findings.


Journal

Acta oto-laryngologica
ISSN: 1651-2251
Titre abrégé: Acta Otolaryngol
Pays: England
ID NLM: 0370354

Informations de publication

Date de publication:
Dec 2020
Historique:
pubmed: 28 8 2020
medline: 11 9 2021
entrez: 28 8 2020
Statut: ppublish

Résumé

Malignant otitis externa is an uncommon but critical challenging disease with some degree of cranial nerve involvement. to examine the factors leading to facial paralysis in these patients and clarify indications for aggressive treatment in the group most at risk. In a case-control study, demographic, clinical, laboratory, audiometric, imaging, and treatment characteristics of 139 patients in groups with and without facial paralysis were analysed. 45 patients (32.4%) had facial paralysis. Compared to patients without facial nerve involvement, patients with facial palsy had a higher rate of inflammatory markers (mean erythrocyte sedimentation rate on admission [67.71 vs 51.16 mm/h], and the average of total ESR [64.27 vs 54.46 mm/h], as well as the mean C-reactive protein [38.96 vs 27.53 mg/L]). Also, the involvement of the facial canal ( Nasopharyngeal extension of the inflammation and facial nerve canal erosion might be useful as predictors of facial nerve dysfunction. The elevated erythrocyte sedimentation rate is correlated with the increased risk of facial paralysis, and aggressive medical management is more crucial. Improvement in predicting the outcome of patients with malignant otitis externa.

Sections du résumé

BACKGROUND BACKGROUND
Malignant otitis externa is an uncommon but critical challenging disease with some degree of cranial nerve involvement.
AIM/OBJECTIVE OBJECTIVE
to examine the factors leading to facial paralysis in these patients and clarify indications for aggressive treatment in the group most at risk.
MATERIAL AND METHODS METHODS
In a case-control study, demographic, clinical, laboratory, audiometric, imaging, and treatment characteristics of 139 patients in groups with and without facial paralysis were analysed.
RESULTS RESULTS
45 patients (32.4%) had facial paralysis. Compared to patients without facial nerve involvement, patients with facial palsy had a higher rate of inflammatory markers (mean erythrocyte sedimentation rate on admission [67.71 vs 51.16 mm/h], and the average of total ESR [64.27 vs 54.46 mm/h], as well as the mean C-reactive protein [38.96 vs 27.53 mg/L]). Also, the involvement of the facial canal (
CONCLUSION CONCLUSIONS
Nasopharyngeal extension of the inflammation and facial nerve canal erosion might be useful as predictors of facial nerve dysfunction. The elevated erythrocyte sedimentation rate is correlated with the increased risk of facial paralysis, and aggressive medical management is more crucial.
SIGNIFICANCE CONCLUSIONS
Improvement in predicting the outcome of patients with malignant otitis externa.

Identifiants

pubmed: 32852248
doi: 10.1080/00016489.2020.1808242
doi:

Substances chimiques

Anti-Bacterial Agents 0
Antifungal Agents 0

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1056-1060

Auteurs

Sasan Dabiri (S)

Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Narges Karrabi (N)

Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Nasrin Yazdani (N)

Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Ahmad Rahimian (A)

Otorhinolaryngology Research Center, Department of Otolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Azita Kheiltash (A)

Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Mehrdad Hasibi (M)

Department of Internal Medicine (Infectious Diseases division), Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Elham Saedi (E)

Department of Internal Medicine (Neurology division), Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

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Classifications MeSH