Paediatric Peripheral Facial Nerve Palsy‐The Role of Ear Pathology

BACKGROUND: Nearly half of the acquired cases of peripheral facial nerve palsy (PFNP) are of unknown aetiology, a condition termed Bell's palsy (BP). PFNP in children can often be associated with acute otitis media (OM). Differences between the clinical course and prognosis in OM-associated PFNP (OM-PFNP) and BP in children are not well characterised. METHODS: Retrospective review of hospitalised children in a tertiary care children's hospital due to non-traumatic and non-surgery associated with PFNP. RESULTS: Out of 177 children hospitalised with facial nerve palsy, 46 were excluded. A total of 131 cases of PFNP were included in the study, 80 with OM-PFNP and 51 with BP. Children with OM-PFNP were younger at presentation (38.8 ± 50.4 vs. 96.6 ± 74.7 months, p < 0.001), presented more frequently during the winter months (32.5% vs. 25.5%, p < 0.05), and had a higher CRP value [median (IQR): 1.3 (0.18-4.2) vs. 0 (0-0) mg/dL, p < 0.005]. There was no significant difference in the corticosteroid use rate (87.5% vs. 88.2%, p = 0.9). Four children with OM-PFNP (and none of the BP group) had an additional underlying pathology. CONCLUSIONS: Children with OM-PFNP are younger at presentation and should be assessed for the presence of a significant associated middle ear/petrous bone pathology.