Facial Nerve Palsy Secondary to Parotid Abscess: Report of a Rare Case and Review of the Literature

A parotid lesion with facial nerve involvement almost always indicates malignancy. Facial nerve palsy as a complication of parotid abscess is extremely rare. The postulated mechanisms include ischaemic neuropathy secondary to the compression of the facial nerve by the parotid swelling, local toxic effect and perineuritis from the inflammatory process. Here, we present our experience in managing a case of facial nerve palsy due to a parotid abscess in an otherwise healthy 44-year-old female. The abscess was drained surgically and the facial nerve function returned to normal at two months. Histopathological examination of the parotid tissue showed no features of malignancy. The severity of facial nerve impairment varied from grade II to total palsy. The mainstay of treatment of a parotid abscess is surgical drainage along with medical therapy including broad-spectrum antibiotics, adequate hydration and sialogogues.