The objectives of this report were to compare clinical course and therapeutic processes in cases of postoperative facial palsy. Case 1 complained of right-side hearing loss and otorrhea caused by middle ear cholesteatoma. This case was diagnosed as delayed facial palsy (DFP) after middle ear surgery and conservative therapy was conducted. In this case, facial palsy occurred suddenly and recovered from H-B grade 5 to grade 2 by 6 months postoperatively. Case 2 involved incidental detection of petrous bone cholesteatoma (PBC), classified as supralabyrinthine cholesteatoma by Sanna and as supralabyrinthine apical cholesteatoma by Moffat-Smith. Postoperative facial weakness gradually increased within 1 month, reaching H-B grade 5 by 6 months postoperatively. And granulation tissue revealed on MRI was coincident with facial palsy.
In this case, conservative therapies proved ineffective and revision surgery was selected. This case was managed with a cable graft using the great auricular nerve.
We experienced such rare facial palsy and reaffirmed the significance of intraoperative neuro-monitering.
