Abstract
Cochlear implantation has many complications; however, delayed facial palsy is relatively
rare. In this report, we present the case of a 60-year-old woman with delayed facial
palsy after cochlear implantation. Eleven days after the operation, the patient complained
of right facial palsy (Yanagihara score 6, House–Brackmann [HB] grade VI). Herpes
virus reactivation and local bacterial infection were considered as possible causes
of the facial paralysis. A blood test revealed an increase in viral antibody titer,
and the patient was diagnosed as having herpes virus reactivation. She was treated
with antiviral therapy for the facial palsy until resolution. Slight mouth weakness
continued even at 1.5 months (Yanagihara score 34, HB II) but eventually resolved
at 3 months (Yanagihara score 40, HB I). Delayed facial palsy is a rare but serious
complication that can occur with viral reactivation regardless of the competence of
the surgical procedure. Therefore, it is important to inform patients preoperatively
regarding the risk of not only immediate but also delayed postoperative facial paralysis.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Auris Nasus LarynxAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Facial palsy following cochlear implantation.Eur Arch Otorhinolaryngol. 2016; 273: 4199-4207
- Cochlear implant complications in 403 patients: comparative study of adults and children and review of the literature.Eur Ann Otorhinolaryngol Head Neck Dis. 2014; 131: 177-182
- [Delayed facial nerve palsy after otologic surgery].Nippon Jibiinkoka Gakkai Kaiho. 2006; 109: 600-605
- Delayed facial palsy following uneventful middle ear surgery: a herpes simplex virus type 1 reactivation?.Ann Otol Rhinol Laryngol. 1998; 107: 901-905
- [Assessment of anti-VZV IgG antibodies in patients with facial palsy. Comparison between CF, FA and EIA].Facial N Res Jpn. 2004; 24: 53-56
- Facial palsy and infection: the unfolding story.Clin Infect Dis. 1992; 14: 263-271
- [Significance of serum HSV antibody titer determination in patients with peripheral facial nerve paralysis].Facial N Res Jpn. 2004; 24: 49-51
- Reactivation of herpes simplex virus type 1 and varicella-zoster virus and therapeutic effects of combination therapy with prednisolone and valacyclovir in patients with Bell's palsy.Laryngoscope. 2007; 117: 147-156
- Caiaffa Filho HH. Herpes simplex virus in the saliva of peripheral Bell's palsy patients.Braz J Otorhinolaryngol. 2006; 72: 7-11
- [Secretion and dynamics of herpes simplex virus in tear and saliva of patients with Bell's palsy].Nippon Jibiinkoka Gakkai Kaiho. 2001; 104: 1078-1088
- HSV-1 DNA in tears and saliva of normal adults.Invest Ophthalmol Vis Sci. 2005; 46: 241-247
- Meta-analysis of delayed facial palsy following middle ear surgery.Otol Neurotol. 2019; 40: 1109-1115
- Delayed peripheral facial palsy in the stapes surgery: can it be prevented?.Am J Otolaryngol. 2004; 25: 105-108
- Association of herpes simplex virus infection and Bell's palsy.J Pak Med Assoc. 2009; 59: 823-825
- Specific IgG and IgA antibodies to herpes simplex virus and varicella zoster virus in acute peripheral facial palsy patients.J Med Virol. 1983; 12: 237-245
- The prevalence and clinical course of facial nerve paresis following cochlear implant surgery.Laryngoscope. 2013; 123: 1000-1004
Article Info
Publication History
Published online: March 15, 2021
Accepted:
March 2,
2021
Received:
June 10,
2020
Identification
Copyright
© 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
