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Fichera P, Bruschini L, Berrettini S, Capobianco S, Fiacchini G. Acute Otitis Media and Facial Paralysis in Children: A Systemic Review and Proposal of an Operative Algorithm. Audiol Res 2023; 13:889-897. [PMID: 37987335 PMCID: PMC10660501 DOI: 10.3390/audiolres13060077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/07/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Acute otitis media (AOM) is one of the most common ENT diseases in children. In the antibiotic/post-antibiotic era, facial paralysis is a very rare complication of AOM (0.004-0.005%). Despite the rarity of this complication, it should be known by all physicians for proper therapeutic management to avoid serious sequelae. The aim of this review is to provide a management guide based on the current literature. MATERIALS AND METHODS Fifteen studies published between 2000 and 2022 were selected, including 120 patients (62 M/58 F) with an average age of 4.96 years old (range = 4 months-16 years; SD: 4.2). The paralysis frequently has a sudden onset and is of a severe grade (medium House-Brackmann (HB) score at onset: 4.68; SD: 0.5); however, it tends to have an almost complete recovery in most patients (88.49% HB 1 at follow-up). RESULTS Its first-line treatment must be based on the use of antibiotics (beta-lactam antibiotics as penicillins or cephalosporins). Corticosteroids should be used concomitantly for their anti-inflammatory and neuroprotective actions; however, there is no unanimity between authors about their application. Myringotomy, with or without ventilation tube insertion, is indicated in cases where the tympanic membrane is intact. Other kinds of surgery should be performed only in patients who have a worsening of their AOM symptoms or a worsening in HB score even with clinical treatment. CONCLUSIONS The obtained data show that a conservative treatment can be sufficient for complete recovery in most patients, and it is preferred as the first-line therapy. Mastoidectomy should be performed only in patients with acute mastoiditis and without symptom improvement after a conservative approach. There are insufficient data in the current literature to provide clear selection criteria for patients who need to undergo mastoidectomy with facial nerve decompression. The choice of this treatment is based on an individual center expertise. Further studies are needed to clarify the role of corticosteroids and the role of facial nerve decompression in this clinical scenario.
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Affiliation(s)
- Piergabriele Fichera
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Via Paradisa, 2, 56126 Pisa, Italy; (L.B.); (S.B.); (S.C.); (G.F.)
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Castellazzi ML, Torretta S, Pietro GMD, Ciabatta A, Capaccio P, Caschera L, Marchisio P. Acute otitis media-related facial nerve palsy in a child: a case report and a literary review. Ital J Pediatr 2023; 49:8. [PMID: 36641446 PMCID: PMC9840536 DOI: 10.1186/s13052-022-01405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Acute otitis media has become a rare cause of facial palsy in children. A high index of suspicion is essential to achieve the diagnosis and to properly treat this condition to avoid permanent neurological sequelae. CASE PRESENTATION A case of acute otitis media-related facial nerve palsy in an 18 months-old child is described and a review of the recent literature about the clinical presentation, diagnosis, and management of this condition is performed. CONCLUSIONS Facial paralysis is an uncommon complication of acute otitis media that requires appropriate care. As highlighted in our report, the treatment of facial nerve palsy secondary to otitis media should be conservative, using antibiotics and corticosteroids. The role of antiviral is still a matter of debate. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. More aggressive surgical approach should be considered only when there is no significant improvement.
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Affiliation(s)
- Massimo Luca Castellazzi
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Emergency Department, Via Commenda 9, 20122 Milan, Italy
| | - Sara Torretta
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Specialistic Surgical Sciences, University of Milan, Milan, Italy
| | - Giada Maria Di Pietro
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Annaclara Ciabatta
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pasquale Capaccio
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Luca Caschera
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy
| | - Paola Marchisio
- grid.414818.00000 0004 1757 8749Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy ,grid.4708.b0000 0004 1757 2822Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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DHI Increases the Proliferation and Migration of Schwann Cells Through the PI3K/AKT Pathway and the Expression of CXCL12 and GDNF to Promote Facial Nerve Function Repair. Neurochem Res 2022; 47:1329-1340. [PMID: 35080688 DOI: 10.1007/s11064-022-03532-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The facial nerve is one of the vulnerable nerves in otolaryngology. Repair and recovery of facial nerve injury have a high priority in clinical practice. The proliferation and migration of Schwann cells are considered of great significance in the process of nerve injury repair. Danhong injection (DHI), as a common drug for cardiovascular and cerebrovascular diseases, has been fully certified in neuroprotection research, but its role in facial nerve injury is still not clear. Our study found that DHI can promote the proliferation and migration of RSC96 cells, a Schwann cell line, and this effect is related to the activation of the PI3K/AKT pathway. LY294002, an inhibitor of PI3K, inhibits the proliferation and migration of RSC96 cells. Further studies have found that DHI can also promote the expression of CXCL12 and GDNF at gene and protein levels, and CXCL12 is, while GDNF is not, PI3K/AKT pathway-dependent. Animal experiments also confirmed that DHI could promote CXCL12 and GDNF expression and promote facial nerve function recovery and myelin regeneration. In conclusion, our in vitro and in vivo experiments demonstrated that DHI could promote the proliferation and migration of Schwann cells through the PI3K/AKT pathway and increase the expression of CXCL12 and GDNF to promote facial nerve function repair.
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Liang F, Fu X, Ding S, Li L. Use of a Network-Based Method to Identify Latent Genes Associated with Hearing Loss in Children. Front Cell Dev Biol 2021; 9:783500. [PMID: 34912812 PMCID: PMC8667072 DOI: 10.3389/fcell.2021.783500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Hearing loss is a total or partial inability to hear. Approximately 5% of people worldwide experience this condition. Hearing capacity is closely related to language, social, and basic emotional development; hearing loss is particularly serious in children. The pathogenesis of childhood hearing loss remains poorly understood. Here, we sought to identify new genes potentially associated with two types of hearing loss in children: congenital deafness and otitis media. We used a network-based method incorporating a random walk with restart algorithm, as well as a protein-protein interaction framework, to identify genes potentially associated with either pathogenesis. A following screening procedure was performed and 18 and 87 genes were identified, which potentially involved in the development of congenital deafness or otitis media, respectively. These findings provide novel biomarkers for clinical screening of childhood deafness; they contribute to a genetic understanding of the pathogenetic mechanisms involved.
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Affiliation(s)
- Feng Liang
- Anaesthesia Department, China-Japan Union Hospital, JiLin University, Changchun, China
| | - Xin Fu
- Anaesthesia Department, China-Japan Union Hospital, JiLin University, Changchun, China
| | - ShiJian Ding
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Lin Li
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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Yamaguchi M, Suzuki M, Morita M, Hasegawa S, Ito Y. Facial nerve palsy with acute otitis media associated with EB virus infection. Pediatr Int 2021; 63:599-600. [PMID: 33764602 DOI: 10.1111/ped.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/15/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Makoto Yamaguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Pediatrics, Nagoya Memorial hospital, Nagoya, Japan
| | - Michio Suzuki
- Department of Pediatrics, Nagoya Memorial hospital, Nagoya, Japan
| | - Makoto Morita
- Department of Pediatrics, Nagoya Memorial hospital, Nagoya, Japan
| | - Shinji Hasegawa
- Department of Pediatrics, Nagoya Memorial hospital, Nagoya, Japan
| | - Yoshinori Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Abstract
Salivary gland diseases are rare. In the European Union (EU) a disease is considered to be rare if not more than 5 of 10,000 people are affected by it. According to estimates in Germany are about 4 million people with a rare disease. In the EU are about 30 million people with rare diseases [1]. In the present work most of the described diseases of salivary glands and of the facial nerve fall in this category. They form a very heterogeneous group whose treatment takes place mainly in specialized centers. Still, it is essential for the otolaryngologist to identify and to diagnose these diseases in order to initiate the right therapeutic steps. The work is a compilation of innate andacquired rare salivary gland disorders and of rare facial nerve disorders. The etiologies of inflammatory diseases, autoimmune disorders and tumors are taken into account. For the individual topics, the current literature, if available, was evaluated and turned into summarized facts. In this context the development of new processes, diagnostics, imaging and therapy are considered. Genetic backgrounds of salivary gland tumors and the trends in the treatment of tumorous lesions of the facial nerve are picked up. Furthermore, also rare diseases of the salivary glands in childhood are described. Some of them can occur in adults as well, but differ in frequency and symptoms. Due to the rarity of these diseases, it is recommended to tread these in centers with special expertise for it. Finally, the difficulties of initiation of studies and the problems of establishing disease registries concerning salivary gland disorders are discussed. This is very relevant because these pathologies are comparatively seldom.
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Affiliation(s)
- Claudia Scherl
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie,
Universitätsklinikum Mannheim
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Yokoyama T, Takemura Y, Kuroda R, Taniguchi C, Jinkawa A, Yamamiya M, Obata M, Miyashita K, Inoue M, Sakazume S, Ohta K. Facial nerve palsy with splenomegaly. J Paediatr Child Health 2020; 56:974-975. [PMID: 31850606 DOI: 10.1111/jpc.14728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 11/23/2019] [Accepted: 11/28/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Tadafumi Yokoyama
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Yuta Takemura
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Rie Kuroda
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Chihiro Taniguchi
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Asumi Jinkawa
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Mari Yamamiya
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Misato Obata
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Kengo Miyashita
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Mika Inoue
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Shinobu Sakazume
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
| | - Kazuhide Ohta
- Department of Pediatrics, National Hospital Organization, Kanazawa Medical Center, Ishikawa, Japan
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Guess KE, Harada Y, Hill A, Ferry J, Veerapandiyan A. A Toddler With Bilateral Facial Weakness. Clin Pediatr (Phila) 2020; 59:529-531. [PMID: 31948285 DOI: 10.1177/0009922819901007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Katherine E Guess
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yohei Harada
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aubrey Hill
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer Ferry
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aravindhan Veerapandiyan
- Arkansas Children's Hospital, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Álvarez-Argüelles ME, Rojo-Alba S, Rodríguez Pérez M, Abreu-Salinas F, de Lucio Delgado A, Melón García S. Infant Facial Paralysis Associated with Epstein-Barr Virus Infection. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1216-1219. [PMID: 31420529 PMCID: PMC6711264 DOI: 10.12659/ajcr.917318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patient: Male, 23 months Final Diagnosis: Peripheral facial paralysis associated with Epstein-Barr virus infection Symptoms: Facial paralysis Medication: — Clinical Procedure: Microbiology diagnosis Specialty: Infectious Diseases
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Affiliation(s)
- Marta E Álvarez-Argüelles
- Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain
| | - Susana Rojo-Alba
- Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain
| | - Mercedes Rodríguez Pérez
- Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain
| | - Fátima Abreu-Salinas
- Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain
| | - Ana de Lucio Delgado
- Department of Paediatric, Central University Hospital of Asturias, Oviedo, Spain
| | - Santiago Melón García
- Department of Microbiology, Unit of Virology, Central University Hospital of Asturias, Oviedo, Spain
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Infectious causes of peripheral facial nerve palsy in children-a retrospective cohort study with long-term follow-up. Eur J Clin Microbiol Infect Dis 2019; 38:2177-2184. [PMID: 31372902 DOI: 10.1007/s10096-019-03660-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 07/23/2019] [Indexed: 12/24/2022]
Abstract
The aim of this study was to analyze the clinical and laboratory characteristics of children with peripheral facial nerve palsy (pFP) with a focus on identifying infectious etiology and long-term outcome. We conducted an ICD-10-based retrospective chart review on children hospitalized with pFP between January 1, 2006, and December 31, 2016. Furthermore, a telephone-based follow-up survey was performed. A total of 158 patients were identified, with a median age of 10.9 years (interquartile range 6.4-13.7). An infectious disease was associated with pFP in 82 patients (51.9%); 73 cases were classified as idiopathic pFP (46.2%). Three cases occurred postoperatively or due to a peripheral tumor. Among the infectious diseases, we identified 33 cases of neuroborreliosis and 12 viral infections of the central nervous system (CNS), caused by the varicella-zoster virus, human herpesvirus 6, herpes simplex virus, enterovirus, and Epstein-Barr virus. Other infections were mainly respiratory tract infections (RTIs; 37 cases). Children with an associated CNS infection had more often headache and nuchal rigidity, a higher cerebrospinal fluid cell count, and a longer length of hospital stay. Long-term follow-up revealed an associated lower risk of relapse in CNS infection-associated pFP. Among all groups, permanent sequelae were associated with female sex, a shorter length of hospitalization, and a lower white blood cell count at presentation. pFP is frequently caused by an CNS infection or is associated with concurrent RTIs, with a potential impact on the short- and long-term clinical course.
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