{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:18:28Z","timestamp":1792019908871,"version":"4.4.0"},"reference-count":68,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To report 4 cases of delayed facial palsy (DFP) after pediatric middle ear (ME) surgery and systematically review and analyze the associated literature to evaluate the effects of age on DFP etiology, management, and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Systematic review of PubMed, Cochrane Library, and Embase for articles related to DFP after cochlear implantation (CI) was performed. These articles were assessed for level of evidence, methodological limitations, and number of cases. Meta-analysis was performed to assess the effects of age on DFP incidence. Furthermore, a comprehensive list of all pediatric DFP cases after otologic surgery was assembled through a multi-institutional retrospective review and systematic review of the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-nine articles fit the criteria for inclusion in the meta-analysis. The incidence of DFP after CI was 0.23% and 1.01% for pediatric and adult cases, respectively. This difference was statistically significant ( P\u2009&lt;\u2009.001, odds ratio 4.36). Twenty-three cases, adding to the 4 presented herein, were suitable for a comprehensive list. The mean age was 6.9\u2009years. Average postoperative day of paresis onset was 5.4, with an average maximum House\u2013Brackmann grade of 3.5. All patients obtained full facial recovery after an average of 23.5\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The systematic review demonstrates that DFP after pediatric CI is rare and occurs at a significantly lower rate than in adults, further supporting the viral reactivation hypothesis of DFP. The prognosis for pediatric DFP after otologic surgery is excellent, with a high rate of full recovery in a short time frame. However, steroid administration can be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>IIa<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894211053966","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T02:53:23Z","timestamp":1635389603000},"page":"1092-1101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Age on Delayed Facial Palsy After Otologic Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8923-6527","authenticated-orcid":false,"given":"Benjamin D.","family":"Lovin","sequence":"first","affiliation":[{"name":"Bobby R. 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Alford Department of Otolaryngology\u2014Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA"},{"name":"Division of Otolaryngology, Department of Surgery\u2014Head and Neck Surgery, Texas Children\u2019s Hospital, Houston, TX, USA"},{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa Claire","family":"Chapel","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristan","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Pediatric Otolaryngology, Department of Otolaryngology\u2014Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Govil","sequence":"additional","affiliation":[{"name":"Pediatric Otolaryngology, Department of Otolaryngology\u2014Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Division of Pediatric Otolaryngology, Children\u2019s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1575-0571","authenticated-orcid":false,"given":"Yi-Chun Carol","family":"Liu","sequence":"additional","affiliation":[{"name":"Bobby R. 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