IX Retrograde Facial Paralysis

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Abstract
An attempt is made to add a new entity to the classical recognized etiologies of peripheral facial paralysis. Peripheral facial paralysis was found co-existing with inflammatory reactions of the external canal and tympanic membrane in 4 cases. These are described in detail. Several similar cases which have previously been described in the literature are mentioned. Anatomical studies are brought forward to show that the chorda tympani nerve lies under the tympanic membrane endothelium and is linked with the subepithelial connective tissue of the medial portion of the external canal skin. This anatomical relationship creates a surgical compartment comprising on the one end the drum on its various layers as well as the skin of the external canal, and on the other hand the epineural connective tissue of the vertical descending facial nerve in the Fallopian canal, bridged by the chorda tympani epineural connective tissue. The possibility is brought forward that infections which spread in surgical compartments can cross from the drum and medial part of the external ear canal, by way of the chorda tympani, to the epineural tissue of the facial nerve and cause a retrograde facial paralysis. Biopsies taken from relevant places are brought forward to sustain this hypothesis.

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