{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:28:07Z","timestamp":1789223287980,"version":"build-2803163510"},"reference-count":7,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":4429,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>This study reviewed patients with unilateral facial paralysis and normal clinical and imaging findings who underwent diagnostic facial nerve exploration.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND SETTING<\/jats:title><jats:p>Fifteen patients with facial paralysis and normal findings were seen in the Mayo Clinic Department of Otorhinolaryngology.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eleven patients were misdiagnosed as having Bell palsy or idiopathic paralysis. Progressive facial paralysis with sequential involvement of adjacent facial nerve branches occurred in all 15 patients. Seven patients had a history of regional skin squamous cell carcinoma, 13 patients had surgical exploration to rule out a neoplastic process, and 2 patients had negative exploration. At last follow\u2010up, 5 patients were alive.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with facial paralysis and normal clinical and imaging findings should be considered for facial nerve exploration when the patient has a history of pain or regional skin cancer, involvement of other cranial nerves, and prolonged facial paralysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>SIGNIFICANCE<\/jats:title><jats:p>Occult malignancy of the facial nerve may cause unilateral facial paralysis in patients with normal clinical and imaging findings. (Otolaryngol Head Neck Surg 2004;130:459\u201365.)<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2003.12.013","type":"journal-article","created":{"date-parts":[[2004,4,26]],"date-time":"2004-04-26T05:21:14Z","timestamp":1082956874000},"page":"459-465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Facial Nerve Paralysis Secondary to Occult Malignant Neoplasms"],"prefix":"10.1002","volume":"130","author":[{"given":"Derek O.","family":"Boahene","sequence":"first","affiliation":[{"name":"Departments of Otorhinolaryngology Rochester Minnesota"},{"name":"Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry D.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Departments of Otorhinolaryngology Rochester Minnesota"},{"name":"Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Departments of Otorhinolaryngology Rochester Minnesota"},{"name":"Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Departments of Otorhinolaryngology Rochester Minnesota"},{"name":"Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Departments of Otorhinolaryngology Rochester Minnesota"},{"name":"Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"ORL\u2010710","article-title":"Facial palsy: Interpretation of neurologic findings","volume":"84","author":"May M","year":"1977","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"e_1_2_5_3_1","first-page":"275","volume-title":"Otolaryngology","author":"Shambaugh GE","year":"1973"},{"key":"e_1_2_5_4_1","first-page":"448","volume-title":"Facial nerve surgery","author":"Fisch U","year":"1977"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198010000-00001"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1988.01860140093029"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.126.4.506"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199602000-00026"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2003.12.013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.otohns.2003.12.013","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2003.12.013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:41:04Z","timestamp":1760956864000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2003.12.013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,4]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2004,4]]}},"alternative-id":["10.1016\/j.otohns.2003.12.013"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2003.12.013","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,4]]},"assertion":[{"value":"2016-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}