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Titolo:
Delayed facial palsy after stapedectomy
Autore:
Shea, JJ; Ge, XX;
Indirizzi:
Shea Ear Clin, Memphis, TN 38119 USA Shea Ear Clin Memphis TN USA 38119Shea Ear Clin, Memphis, TN 38119 USA
Titolo Testata:
OTOLOGY & NEUROTOLOGY
fascicolo: 4, volume: 22, anno: 2001,
pagine: 465 - 470
SICI:
1531-7129(200107)22:4<465:DFPAS>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
HERPES-SIMPLEX VIRUS; VARICELLA-ZOSTER VIRUS; MIDDLE-EAR SURGERY; BELLS-PALSY; REACTIVATION; PARALYSIS; NERVE; DECOMPRESSION;
Keywords:
delayed facial palsy; stapedectomy; serum antibody titer; reactivation; herpes simplex virus; varicella zoster virus; acyclovir;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Shea, JJ Shea Ear Clin, 6133 Poplar Pike, Memphis, TN 38119 USA Shea Ear Clin 6133 Poplar Pike Memphis TN USA 38119 TN 38119 USA
Citazione:
J.J. Shea e X.X. Ge, "Delayed facial palsy after stapedectomy", OTOL NEURO, 22(4), 2001, pp. 465-470

Abstract

Objective: To study the incidence, pathogenesis, and prevention of delayedfacial palsy after stapedectomy. Study Design: Retrospective case review. Setting: Otology/neurotology referral center. Patients: A series of 2152 stapedectomy procedures in 2106 patients over 12 years. Intervention: Delayed facial palsy after stapedectomy was studied. Main Outcome Measure: House-Brackmann facial nerve grading system and serum antibody titer tests for herpes simplex virus type I and type II, and varicella tester virus. Results: Delayed facial palsy occurred in 11 of 2152 procedures. Delayed facial palsy occurred from 5 to 16 days (mean 8) after stapedectomy. Predisposing factors were bony facial canal dehiscence with bare or bulging facialnerve herniation in 5 patients; chorda tympani nerve stretched, manipulated, or cut in 2 patients; granulomatous reaction to Gelfoam in 1 patient; fever blisters on the upper lip in 1 patient; and sinusitis in 2 patients. Elevated anti-varicella antibody titers were found in all 6 patients studied. Anti-herpes simplex type I and II antibody titers were elevated in 5 of 6 patients. Acyclovir was effective in preventing delayed facial palsy in 1 patient who had undergone revision stapedectomy and experienced delayed facial palsy after previous stapedectomy in the same ear with elevated anti-herpes antibody titer. Conclusions: Delayed facial palsy occurred in 0.51% of patients after stapedectomy. Serologic investigation suggests activation of latent herpesvirus. Mechanical irritation of the facial or chorda nerve during operation may trigger the activation. The anti-herpesvirus agent acyclovir may prevent delayed facial palsy after stapedectomy in patients suspected of having this complication.

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Documento generato il 22/02/20 alle ore 21:28:53