Abstract Although rare, complications of acute otitis media may develop depending on the disease severity and the immune response of the host. Once developed, the complications may cause significant morbidity to the patient. Facial nerve paralysis as a complication of acute otitis media is rare but warrants proper medical care, including antimicrobial and corticosteroid therapy. However, labyrinthine fistula is seldom reported in association with acute otitis media. Here, we report the case of a 6-year-old boy developing facial nerve paralysis, mastoiditis, and labyrinthine fistula as complications of acute otitis media. The child initially had left otalgia preceded by fever and upper respiratory tract infection 15 days back, but eventually developed ipsilateral facial nerve paralysis and mastoiditis. Bony dehiscence over the horizontal part of the facial canal and lateral semicircular canal on the left side were found in the computed tomography scan of the temporal bones. As conservative management was unable to control the disease progression, a mastoid exploration was performed with complete removal of the infective foci from the middle ear cleft. Despite the absence of cholesteatoma or similar pathology, a fistula over the lateral semicircular canal and dehiscence of the horizontal facial canal were found. The boy recovered uneventfully with improved facial nerve functions.
Jotdar et al. (Tue,) studied this question.