Facial paralysis

Facial paralysis can be a central or peripheral. The most common facial paralysis is peripheral and known as Bell’s palsy.

An otoscopy is essential to eliminate a middle ear disorder. In the case of acute otitis media or serous otitis associated with facial paralysis, patient must be referred in emergency to an ENT for a myringotomy and transtympanic tube installation. The ENT proceeds to the palpation of the neck and parotid gland to detect a possible cervical lymphadenopathy or parotid masses. A full neurological examination should be performed to rule out other associated deficits.

 

 

In the case of traumatic facial paralysis it is mandatory to know if the paralysis was immediate or delayed.

However, in the absence of conditions that could cause secondary facial paralysis, a corticosteroid therapy and an oral antiviral should be undertaken as soon as possible. Special attention must be paid to the eye on the same side of the paralysis. It is important to prevent the cornea from drying and dust from entering the eye. We must therefore systematically protect the cornea by applying a lubricant ointment or by making a complete lid closure at night and regularly instilling artificial tears. In addition, it is essential to protect the eye at night using an occlusive dressing and avoid bright lights or strong winds during the day. The exposure of the cornea can be complicated by keratitis. In doubt, do not hesitate to request a consultation in ophthalmology.

Reference: Le Médecin du Québec, Volume 42, Number 5, May 2007

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Emergency in ENT
Peritonsillar abscess
Ludwig’s Angina
Foreign body in the ear
Foreign body in the respiratory tract (nose, trachea, bronchi)
Foreign body in the esophagus
Epiglottitis
Epistaxis
Perilymphatic fistula
Nose fracture
Hemorrhage post-adenotonsillectomy
Acute mastoiditis
Facial paralysis
Sudden hearing loss