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Predictive role of facial nerve palsy improvement in malignant external otitis

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effects of different factors on facial nerve palsy improvement in patients with malignant external otitis (MEO) and the predictive role of improvement on MEO.

Methods

Data were collected from all MEO patients with facial paralysis who were hospitalized between 2012 and 2017 at a tertiary referral center. We contacted patients at least 6 months after their admission to evaluate their facial nerve function and survival rate.

Results

In a study of 19 samples with a mean age of 69.1 years, 9 patients (47.7%) had some or complete improvement, while 10 (52.6%) had no or very minimal improvement. In this study, there was no statistically significant difference between patients with and without facial nerve palsy improvement in terms of age, sex, usage of antifungal treatment alongside antibiotics, duration of hospital stays, HbA1c level, presentation of hearing loss and vertigo, the severity of facial palsy, comorbidity score, mean of fasting blood sugar, leukocytosis, first ESR and ESR drop, CRP and physiotherapy. We found a positive correlation between improving facial palsy and patients’ survival rates.

Conclusion

Considering the possible influence of facial paralysis improvement prognosis on MEO patients’ survival, it could affect our approach to the disease.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

References

  1. Mahdyoun P, Pulcini C, Gahide I, Raffaelli C, Savoldelli C, Castillo L et al (2013) Necrotizing otitis externa: a systematic review. Otol Neurotol 34(4):620–629. https://doi.org/10.1097/MAO.0b013e3182804aee

    Article  PubMed  Google Scholar 

  2. Chandler JR (1974) Malignant external otitis and facial paralysis. Otolaryngol Clin N Am 7(2):375–383

    Article  CAS  Google Scholar 

  3. Chandler JR (1977) Malignant external otitis: further considerations. Ann Otol Rhinol Laryngol 86(4 Pt 1):417–428. https://doi.org/10.1177/000348947708600401

    Article  CAS  PubMed  Google Scholar 

  4. Weir A, Pentland B, Crosswaite A, Murray J, Mountain R (1995) Bell’s palsy: the effect on self-image, mood state and social activity. Clin Rehabil 9(2):121–125. https://doi.org/10.1177/026921559500900206

    Article  Google Scholar 

  5. Zonnour A, Jamshidi A, Dabiri S et al (2023) Predictive factors in treatment response of malignant external otitis. Eur Arch Otorhinolaryngol 280:159–166. https://doi.org/10.1007/s00405-022-07478-5

    Article  PubMed  Google Scholar 

  6. House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93(2):146–147. https://doi.org/10.1177/019459988509300202

    Article  CAS  PubMed  Google Scholar 

  7. Franco-Vidal V, Blanchet H, Bebear C, Dutronc H, Darrouzet V (2007) Necrotizing external otitis: a report of 46 cases. Otol Neurotol 28(6):771–773. https://doi.org/10.1097/MAO.0b013e31805153bd

    Article  PubMed  Google Scholar 

  8. Lee SK, Lee SA, Seon SW, Jung JH, Lee JD, Choi JY et al (2017) Analysis of prognostic factors in malignant external otitis. Clin Exp Otorhinolaryngol 10(3):228–235. https://doi.org/10.21053/ceo.2016.00612

    Article  PubMed  Google Scholar 

  9. Soudry E, Joshua BZ, Sulkes J, Nageris BI (2007) Characteristics and prognosis of malignant external otitis with facial paralysis. Arch Otolaryngol Head Neck Surg 133(10):1002–1004. https://doi.org/10.1001/archotol.133.10.1002

    Article  PubMed  Google Scholar 

  10. Auinger AB, Dahm V, Stanisz I, Schwarz-Nemec U, Arnoldner C (2021) The challenging diagnosis and follow-up of skull base osteomyelitis in clinical practice. Eur Arch Otorhinolaryngol 278(12):4681–4688. https://doi.org/10.1007/s00405-020-06576-6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Loh S, Loh WS (2013) Malignant otitis externa: an Asian perspective on treatment outcomes and prognostic factors. Otolaryngol Head Neck Surg 148(6):991–996. https://doi.org/10.1177/0194599813482107

    Article  PubMed  Google Scholar 

  12. Dabiri S, Karrabi N, Yazdani N, Rahimian A, Kheiltash A, Hasibi M et al (2020) Facial nerve paralysis in malignant otitis externa: comparison of the clinical and paraclinical findings. Acta Otolaryngol 140(12):1056–1060. https://doi.org/10.1080/00016489.2020.1808242

    Article  CAS  PubMed  Google Scholar 

  13. Ridder GJ, Breunig C, Kaminsky J, Pfeiffer J (2015) Central skull base osteomyelitis: new insights and implications for diagnosis and treatment. Eur Arch Otorhinolaryngol 272(5):1269–1276. https://doi.org/10.1007/s00405-014-3390-y

    Article  PubMed  Google Scholar 

  14. Mani N, Sudhoff H, Rajagopal S, Moffat D, Axon PR (2007) Cranial nerve involvement in malignant external otitis: implications for clinical outcome. Laryngoscope 117(5):907–910. https://doi.org/10.1097/MLG.0b013e318039b30f

    Article  PubMed  Google Scholar 

  15. Hasibi M, Ashtiani MK, MotassadiZarandi M, Yazdani N, Borghei P, Kuhi A et al (2017) A treatment protocol for management of bacterial and fungal malignant external otitis: a large cohort in Tehran. Iran Ann Otol Rhinol Laryngol 126(7):561–567. https://doi.org/10.1177/0003489417710473

    Article  PubMed  Google Scholar 

  16. Byun YJ, Patel J, Nguyen SA, Lambert PR (2020) Necrotizing otitis externa: a systematic review and analysis of changing trends. Otol Neurotol 41(8):1004–1011. https://doi.org/10.1097/MAO.0000000000002723

    Article  PubMed  Google Scholar 

  17. Lindsay RW, Robinson M, Hadlock TA (2010) Comprehensive facial rehabilitation improves function in people with facial paralysis: a 5-year experience at the Massachusetts Eye and Ear Infirmary. Phys Ther 90(3):391–397. https://doi.org/10.2522/ptj.20090176

    Article  PubMed  Google Scholar 

  18. Robinson MW, Baiungo J (2018) Facial rehabilitation: evaluation and treatment strategies for the patient with facial palsy. Otolaryngol Clin N Am 51(6):1151–1167. https://doi.org/10.1016/j.otc.2018.07.011

    Article  Google Scholar 

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Acknowledgements

This research was extracted from the thesis for the Doctor of Medicine degree at the Medical School of Tehran University of Medical Sciences (thesis number: 9111215092).

Funding

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Amir Alam Hospital, Tehran University of Medical Sciences, North Saadi Ave., Tehran, 11457-65111, Iran

    Abolfazl Jamshidi, Alireza Zonnour, Sasan Dabiri, Ardavan Tajdini, Narges Karrabi & Nasrin Yazdani

  2. Department of Internal Medicine (Infectious Diseases Division), Amir Alam Hospital, Tehran University of Medical Sciences, North Saadi Ave., Tehran, 11457-65111, Iran

    Mehrdad Hasibi

Authors
  1. Abolfazl Jamshidi
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  2. Alireza Zonnour
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  3. Sasan Dabiri
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  4. Mehrdad Hasibi
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  5. Ardavan Tajdini
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  6. Narges Karrabi
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  7. Nasrin Yazdani
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Contributions

AJ: conceptualization, methodology, investigation, writing—original draft, formal analysis, data curation. AZ: writing-review and editing, data curation, resources. SD: methodology, project administration. MH: validation. AT: validation. NK: data curation. Nasrin Yazdani: supervision.

Corresponding author

Correspondence to Nasrin Yazdani.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

This research was approved by the ethical committee of Tehran University of Medical Sciences (number: IR.TUMS.MEDICINE.REC.1397.366).

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Jamshidi, A., Zonnour, A., Dabiri, S. et al. Predictive role of facial nerve palsy improvement in malignant external otitis. Eur Arch Otorhinolaryngol 281, 1253–1258 (2024). https://doi.org/10.1007/s00405-023-08230-3

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  • DOI: https://doi.org/10.1007/s00405-023-08230-3

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