Otomastoiditis-related facial nerve palsy.
A 9-year-old girl with persistent otitis media, despite antibiotic therapy developed a facial nerve palsy. Computed tomography (CT) scan revealed ipsilateral mastoiditis, prompting admission for intravenous antibiotic and steroid therapies. Acute mastoiditis, uncommon in the post-antibiotic era, is usually diagnosed on physical examination findings, but two variants, masked mastoiditis or silent mastoiditis, may be difficult to appreciate clinically. Patients who present with facial nerve palsy in the setting of persistent otitis media should undergo CT scan for evaluation of intracerebral or extracerebral pathology, including mastoiditis. Failure to identify associated concomitant pathology may result in treatment failure or persistent neurological deficit.
Helms
Dawn
D
Emergency Medicine Residency Program, Department of Emergency Medicine, Ohio Valley Medical Center, 2000 Eoff Street, Wheeling, West Virginia 26003, USA
Roberge
Raymond J
RJ
Kovalick
Michael
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D002648:Child; D005155:Facial Nerve Diseases / Q000209:etiology*; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D008416:Mastoid / Q000000981:diagnostic imaging; D008417:Mastoiditis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002444:Cefuroxime; D011241:Prednisone