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Oculostapedial synkinesis following idiopathic facial palsy: something to listen out for

  • T Williams (a1), B Tungland (a2), N Stobbs (a1) and G Watson (a1)

Abstract

Objective

This paper presents a rare case of oculostapedial synkinesis.

Case report

After partial resolution of an idiopathic facial palsy, a male patient presented with persistent distortion of hearing when blinking and closing his eye. Audiometry findings were unremarkable, and cross-sectional imaging of the facial nerve revealed no abnormalities apart from an incidental contralateral meningioma. Initial conservative management, with referral to a specialist physiotherapist, failed to resolve the symptoms. The patient subsequently opted for surgical intervention, and underwent a transmeatal tympanotomy and transection of the stapedial tendon. Following this, he had complete resolution of symptoms.

Conclusion

Oculostapedial synkinesis is a rare complication of facial palsy, but is recognised in the literature. Given its unusual presentation, it can be overlooked, especially by more junior team members. This case highlights the need to pay careful attention to patients' symptoms and listen out for the description of hearing distortion on facial movement.

Copyright

Corresponding author

Author for correspondence: Mr Timothy Williams, ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK E-mail: timothy.williams@sth.nhs.uk Fax: 0114 271 1985

Footnotes

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Mr T Williams takes responsibility for the integrity of the content of the paper

Footnotes

References

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1House, J, Brackmann, D. Facial nerve grading system. Otolaryngol Head Neck Surg 1985;93:146–7
2Watson, G, Glover, S, Allen, S, Irving, R. Outcome of facial physiotherapy in patients with prolonged idiopathic facial palsy. J Laryngol Otol 2015;129:348–52
3Schwarze, H, Hirsch, B, Johnson, P. Oculostapedial synkinesis. Otolaryngol Head Neck Surg 1995;113:802–6
4Ferguson, JH. Hemifacial spasm and the facial nucleus. Ann Neurol 1978;4:97103
5Kim, P, Fukushima, T. Observations on synkinesis in patients with hemifacial spasm. J Neurosurg 1984;60:821–7
6Donne, A, Homer, J, Woodhead, C. Oculostapedial synkinesis following Bell's palsy. J Laryngol Otol 2000;114:135–6
7Kang, J, Hong, B, Chung, W, Hong, S. A case of oculostapedial synkinesis following Bell's palsy [in Korean]. Korea J Otolaryngol 2002;48:817–20
8Fujiwara, K, Furuta, Y, Fukuda, S. Idiopathic oculostapedial synkinesis without history of facial nerve palsy. Otol Neurotol 2015;3:510–12

Keywords

Oculostapedial synkinesis following idiopathic facial palsy: something to listen out for

  • T Williams (a1), B Tungland (a2), N Stobbs (a1) and G Watson (a1)

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