Peripheral facial paralysis associated with internal auditory canal stenosis: case report in a pediatric patient

Abstract

Introduction: Internal auditory canal stenosis (ECAI) is a condition that can lead to hypoplasia or aplasia of the cranial nerves that pass through this structure, which are the vestibulocochlear and facial nerves. The most common condition is sensorineural hearing loss, while peripheral facial paralysis (PFP) is rare. Objective: This article aims to describe a rare case of progressive PFP due to ECAI in a preschool patient attended at the pediatrics ambulatory at a university hospital in Rio de Janeiro. Case description: 3-year-old preschooler, born vaginally, with no complications during pregnancy. The Evoked Otoacoustic Emissions exam was altered on the right side in neonatal screening exams. He presented delays in language development milestones, with speech delay associated with speech articulation disorder (with exchange and omission of phonemes). He developed progressive PFP on the right side, classified as grade IV on the House-Brackmann Scale. Magnetic resonance imaging showed a hypoplastic right internal auditory canal, and hypoplastic right facial and vestibulocochlear nerves without a course within the internal auditory canal. A Brainstem Auditory Evoked Response exam was requested, which showed complete hearing loss in the right ear. Discussion: ECAI should be suspected in patients with ipsilateral sensorineural hearing loss and PFP. In this research, it was observed that malformations of the structures of the inner ear, eyes and kidneys may be associated with the described condition. Hypoacusis in children can cause complications such as delayed language development and school difficulties.