Chronic Otitis Media with Facial Palsy: An Unexpected Etiology

Arpit Saxena*, Dharmendra Kumar Singh and Vivek Raj Sinha

Chronic Otitis Media with Facial Palsy: An Unexpected Etiology.

Chronic otitis media is a commonly observed disease worldwide. Facial palsy in a
patient can be attributed to many causes. Facial paresis with chronic otitis media is almost always attributable to facial palsy.

This article reports the clinical condition of a patient in whom
the etiology of facial paresis was not conventional. However, the unexpected etiology that was
observed could not be located in any pre-existing literature related to facial paresis.

A 13-year-old female, student by occupation presented with a medical history of severe
right sided otalgia for 6 days and facial asymmetry for 4 days. Only 6 months earlier, she had
discharge from her right ear.

There was no history of skin rashes over the ear or face or facial
asymmetry. Otological examination indicated an edematous external auditory canal, moderate
central perforation in the tympanic membrane with granulation tissue in the antero-superior

Right sided lower motor neuron facial palsy was classified as House-Brackmann
grade IV. The tuning fork test demonstrated right side conductive deafness in the affected patient.

Routine hematological and biochemical parameters which were analyzed indicated normal values of measurement. Her chest X-ray report was normal and she tested negative for
human immunodeficiency virus.

In the present case, the red ant possibly entered through the pre-existing perforation in the tympanic
membrane and inoculated its venom into the middle ear.

The presence of the toxin and the dead ant in the middle ear probably led to the formation of the granulation tissue. Facial paresis may have thus been due to the effect of the venom that would have entered the fallopian canal by natural dehiscence.

Otolaryngol Open J. 2017; 3(3): 41-42. doi: 10.17140/OTLOJ-3-140