When should an otologic cause be considered for Bell palsy (idiopathic facial paralysis) (IFP)?

Updated: Jun 14, 2019
  • Author: Danette C Taylor, DO, MS, FACN; Chief Editor: Selim R Benbadis, MD  more...
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Answer

An otologic examination includes pneumatic otoscopy and tuning fork examination. An otologic cause should be considered if the history or physical examination demonstrates evidence of acute or chronic otitis media, including a tympanic membrane perforation, otorrhea, cholesteatoma, or granulation tissue, or if a history of ear surgery is noted. Concurrent rash or vesicles along the ear canal, pinna, and mouth should raise the suspicion for Ramsay Hunt syndrome (herpes zoster oticus).


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