Delayed facial nerve palsy following otological surgery: systematic review and narrative synthesis

Abstract Objectives This study aimed to review the incidence, outcomes and treatment of delayed facial nerve palsy (DFP) following otological surgery. Methods MEDLINE, Pubmed, Embase and The Cochrane Central Register of Controlled Trials were searched up to 10 May 2024. A systematic review was conducted per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of studies reporting on DFP following otological surgery. The risk of bias was assessed using the JBI critical appraisal tools. Results Forty-nine articles were included with 201 instances of DFP following 24,917 operations from 1967 to 2021. The mean day of onset post-operatively was 8.4. 93 per cent of episodes fully recovered, with most cases taking between eight days and one month to recover. Conclusion Many theories of the pathogenesis of DFP exist. It is rare and has an excellent prognosis following treatment with corticosteroids with or without anti-viral therapy.