title: Effect of surgical intervention on middle-ear cholesteatoma with associated facial paralysis.
abstract: OBJECTIVE
  To investigate the presenting symptoms, intra-operative findings and long-term facial nerve function in patients treated for cholesteatoma with associated facial paralysis.
  
  
  METHODS
  Fifteen patients with facial paralysis due to middle-ear cholesteatoma who underwent tympanomastoidectomy surgery from February 2000 to February 2015 were retrospectively reviewed. After removal of the cholesteatoma, a limited area of the fallopian canal, in which facial nerve oedema or redness was evident, was opened. Incision of the epineural sheath for nerve decompression was not performed.
  
  
  RESULTS
  Pre-operative House-Brackmann grade was grade II in two patients, grade III in four, grade IV in seven, grade V in one and grade VI in one. Facial nerve perineurium damage was observed in two patients with poor prognoses. All patients treated within the first 15 days after paralysis onset showed normal facial function at long-term follow up. Post-operative House-Brackmann grade was grade I in 11 patients, grade II in 1, grade III in 2 and grade VI in 1.
  
  
  CONCLUSIONS
  Early surgical treatment is more likely to give good results, and poor outcomes are observed in patients with facial nerve perineurium damage.
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Ozkul
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Songu
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Onal
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Imre
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Arslanoglu
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Horoz
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Bayrak
authors.affiliation: Department of Otorhinolaryngology,Izmir Katip Celebi University Ataturk Training and Research Hospital,Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Pinar
mesh_terms: D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000601:surgery*; D004487:Edema / Q000209:etiology / Q000503:physiopathology*; D005155:Facial Nerve Diseases / Q000209:etiology / Q000503:physiopathology*; D005158:Facial Paralysis / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty
keywords:  Middle Ear; Cholesteatoma; Facial Paralysis; Prognosis