Facial paralysis associated with cholesteatoma: a review of 13 cases

OBJECTIVE: Report the clinical presentation and outcome of the cases of 13 patients with facial paralysis and acquired middle ear and mastoid cholesteatoma. PATIENTS: Patients with acquired cholesteatoma of the middle ear presenting with facial paralysis. INTERVENTIONS: Surgical treatment of the cholesteatoma and decompression of the facial nerve. MAIN OUTCOME MEASURES: The type and the timing of surgery, the intraoperative findings, and the postoperative facial nerve results were analyzed and related to the preoperative facial nerve function. RESULTS: All patients treated less than 7 days after the onset of the paralysis showed a normal facial function at long-term follow-up; patients who were operated on 7 days or more after the onset of paralysis showed a variable outcome. Statistical analysis showed a bigger number of House-Brackmann grade I in patients operated on within the first week of paralysis (p = 0.031). CONCLUSION: The prognosis of facial paralysis is related to the time of intervention. Early diagnosis and treatment of cholesteatoma represent, however, the mainstay of treatment.