Recurrent Facial Paralysis in a 3‐Month‐Old Infant Associated With Acute Otitis Media: A Case Report

Acute otitis media (AOM) is a common pediatric condition, with facial nerve paralysis (FNP) as a rare complication. It occurs in approximately 0.004%–0.005% of cases. This report presents a unique case of a female infant with recurrent FNP related to AOM who experienced four episodes within the first 3 months of life. The patient was referred to our department at the 34th day of life with facial paralysis linked to left AOM. Treatment with intravenous antibiotics and systemic steroids initially improved FNP. Tympanotomy was performed during the second episode, and a tympanostomy tube was inserted during the third episode. However, left facial paralysis persisted after the fourth episode. Imaging studies showed effusion in the middle ear bilaterally, and a horizontal bone defect and peripheral stenosis of the left facial nerve canal. FNP management in AOM remains a subject of debate, with differing recommendations, especially regarding systemic steroid administration. This case highlights the criticality of considering anatomical factors in pediatric patients presenting with FNP and AOM, underscoring the requirement for further research on effective treatment strategies and understanding the pathophysiology of this rare condition.