Minimally invasive endoscopic treatment of chronic otitis media with facial nerve palsy- A case report and literature review

Abstract

Facial nerve palsy is an uncommon yet significant complication of chronic otitis media (COM) which can lead to a permanent cosmetic defect. It is common in cholesteatomatous chronic otitis media. Treatment options include antibiotics, steroids, and surgery. Facial nerve decompression is chiefly performed using a microscope via a postaural approach. It requires mastoidectomy and atticotomy to gain access to the anterior epitympanum and anterior end of the tympanic facial nerve. Here, we present a case of a 40-year-old woman with bilateral chronic otitis media presented with sudden onset of Grade V left facial nerve palsy. On examination, the left ear had cholesteatomatous like debris, granulation, and discharge. Total endoscopic transcanal type III tympanoplasty and facial nerve decompression were done. She had full recovery post-surgery. The endoscope avoided the postaural incision, decreased morbidity, and provided faster recovery.