Facial paralysis caused by cholesteatoma is uncommon. The portions most frequently involved are horizontal (tympanic) and second genu segments. When cholesteatomas extend over the anterior epitympanic space, the facial nerve is placed in jeopardy in the region of the geniculate ganglion. The aetiology can be related to compression of the nerve followed by impairment of its blood supply or production of neurotoxic substances secreted from either the cholesteatoma matrix or bacteria enclosed in the tumor. AIM: To evaluate the incidence, clinical features and treatment of the facial palsy due cholesteatoma. STUDY DESIGN: Clinical retrospective. MATERIAL AND METHOD: Retrospective study of 10 cases of facial paralysis due cholesteatoma selected through a survey of 206 decompressions of the facial nerve due various aetiologies realized in the last 10 years in UNIFESP-EPM. RESULTS: The incidence of facial paralysis due cholesteatoma in this study was 4,85%, with female predominance (60%). The average age of the patients was 39 years. The duration and severity of the facial palsy associated with the extension of lesion were important for the functional recovery of the facial nerve. CONCLUSION: Early surgical approach is necessary in these cases to improve the nerve function more adequately. When disruption or intense fibrous replacement occurs in the facial nerve, nerve grafting (greater auricular/sural nerves) and/or hypoglossal facial anastomosis may be suggested.
cholesteatoma; facial nerve; facial palsy
