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Delayed facial nerve palsy following otological surgery: systematic review and narrative synthesis

Published online by Cambridge University Press:  29 August 2025

Ben Walters Open the ORCID record for Ben Walters [Opens in a new window] ,
Sanjay Patel Open the ORCID record for Sanjay Patel [Opens in a new window] ,
Valerie Kim  and
Hussein Walijee
Ben Walters
Affiliation:
Department of Paediatric Surgery, Sheffield Children’s Hospital, Sheffield, UK
Sanjay Patel*
Affiliation:
Department of ENT, Birmingham Women’s and Children’s Hospital, Birmingham, UK
Valerie Kim
Affiliation:
Department of ENT, NHS Fife, Kirkcaldy, Fife, Scotland, UK
Hussein Walijee
Affiliation:
Department of ENT, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
*
Corresponding author: Sanjay Patel; Email: s.patel9@doctors.org.uk
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Abstract

Objectives

This study aimed to review the incidence, outcomes and treatment of delayed facial nerve palsy (DFP) following otological surgery.

Methods

MEDLINE, Pubmed, Embase and The Cochrane Central Register of Controlled Trials were searched up to 10 May 2024. A systematic review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of studies reporting on DFP following otological surgery. The risk of bias was assessed using the JBI critical appraisal tools.

Results

Forty-nine articles were included with 201 instances of DFP following 24,917 operations from 1967 to 2021. The mean day of onset post-operatively was 8.4. 93 per cent of episodes fully recovered, with most cases taking between eight days and one month to recover.

Conclusion

Many theories of the pathogenesis of DFP exist. It is rare and has an excellent prognosis following treatment with corticosteroids with or without anti-viral therapy.

Keywords

corticosteroidsfacial paralysisherpesvirusPostoperative complicationTympanoplastyChronic Suppurative Otitis MediaStapes SurgeryCochlear Implant SurgeryViral reactivationFacial nerve injuryManagement

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 12 , December 2025 , pp. 1127 - 1135
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

*Contributed equally

Sanjay Patel takes responsibility for the integrity of the content of the paper

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