Two cases of 1-year-old infants with facial paralysis associated with acute otitis media

Abstract

Facial nerve paralysis due to acute otitis media is more common in children than in adults. Treatment can be conservative or surgical; however, there is no standard treatment option in children. In the present study, we describe two cases of facial paralysis associated with acute otitis media of different severity in 1-year-old infants, both of whom recovered by conservative treatment. Patient 1 presented with otorrhea and right facial paralysis following an upper respiratory tract infection that persisted for more than a week. Bilateral severe acute otitis media with right mastoiditis and complete right facial paralysis were observed. The patient was treated conservatively and had recovered by day 74. Patient 2 developed left facial paralysis following a fever, and was administered antiviral drugs and steroids by a pediatrician. The patient developed moderate left acute otitis media the next day. Myringotomy was performed and intravenous antimicrobial drug was administered, and the patient had recovered by day 28.

Our findings suggest that conservative treatment is a suitable first option in infants with acute otitis media and facial paralysis, in the absence of destruction of the mastoid air cells or abscess formation. Surgery may be selected as a secondary option if there is no improvement with conservative treatment.