Most people’s first thought is “stroke” when they say crooked mouth. But did you know? There are many otorhinolaryngological and even orofacial diseases that can also cause symptoms and signs such as crookedness of the corners of the mouth, tongue extension to one side, inability to close the eyes, loss of frontal lines, numbness of facial sensation, loss of taste or even loss of taste, etc. Together, these symptoms and signs are usually called “facial palsy”. Why is this? It starts from the origin of the facial nerve. It originates in the brain, passes through the inner ear, then bifurcates through the parotid gland and innervates the facial expression muscles. If there is a problem with any part of the facial nerve, facial palsy symptoms can occur. As you can see, “facial palsy” does not mean “stroke”. Facial palsy can occur in diseases of the brain, ear and parotid gland. Facial palsy is divided into central and peripheral, and facial palsy caused by ear or parotid gland diseases is peripheral. Today, we will mainly talk about peripheral facial palsy caused by ear and parotid gland diseases and its treatment. 1. Otitis media. It is mainly chronic suppurative otitis media. When this otitis media is prone to invade the facial nerve’s protective umbrella, the facial nerve canal, it will erode it and the facial nerve will be exposed and compressed, causing facial palsy. Acute suppurative otitis media may also lead to facial palsy due to the accumulation of pus in the bone ulcer. Facial palsy caused by the above causes should be operated as soon as possible. In addition, some acute non-suppurative otitis media may also cause facial palsy, which is mainly caused by inflammation and edema of the facial nerve, and the infection can be controlled by general conservative medication. 2. Facial palsy caused by trauma. This includes facial palsy caused by ear surgery, parotid surgery and temporal bone fracture. If the facial nerve is severed during surgery, facial nerve anastomosis or transplantation should be performed as soon as possible, and facial nerve decompression (ear) should be performed in parallel; if the facial nerve is stimulated during ear surgery or swelling may occur, a second surgery or temporary observation with medication should be performed as soon as possible depending on the specific situation, and then facial nerve decompression should be performed if there is no improvement. Swelling of the facial nerve caused by parotid surgery can generally be observed with medication after surgery, and most of them can recover on their own. Conservative treatment usually consists of glucocorticoids and nerve-nourishing drugs. For facial palsy caused by temporal bone fracture, regular conservative treatment is now generally recommended. 3. Facial nerve and parotid tumor. Patients with facial palsy, hearing loss, vertigo, and parotid masses without any cause should undergo CT and MRI examination, and early surgery should be performed after clear diagnosis to remove the tumor and restore the facial nerve function as much as possible. 4. Bell facial palsy. Also known as idiopathic facial palsy, it is an acute peripheral facial palsy, the specific cause of which is unknown. It may be related to viral infection, vascular spasm and local ischemia, and cold, cool wind stimulation and mental trauma may induce the disease. 5, ear herpes zoster. It is caused by varicella-herpes zoster virus. In addition to symptoms of facial paralysis, patients have prodromal symptoms such as low-grade fever, general malaise, headache and unilateral intra- and peri-auricular pain, which is usually severe, and herpes in the auricular cavity and/or ear. In addition, patients often have tinnitus, vertigo, hearing loss, and even balance dysfunction. For facial palsy caused by 4 and 5, vasodilation and nerve nutrition therapy are routinely given. 5 Anti-viral therapy should also be given, including oral or intravenous injection of anti-viral drugs and topical application of anti-viral creams. Most patients can recover through regular drug treatment.