Prognostic significance of clinical, electrophysiological, and immunological changes in facial nerve neuropathies associated with chronic suppurative otitis media

Facial nerve neuropathy associated with chronic suppurative otitis media (CSOM) represents a clinically important peripheral neuropathy in which intratemporal inflammation, compression, ischemia, demyelination, and axonal injury may coexist. The neurological outcome is not determined by otological findings alone; it also depends on the severity of motor dysfunction, axonal preservation, denervation and reinnervation dynamics, brainstem reflex-arc integrity, and the biological intensity of chronic inflammation. This integrative review analyzes the prognostic significance of House Brackmann and Sunnybrook grading, electroneurography/electromyography, blink reflex parameters, temporal-bone disease characteristics, and inflammatory markers including IL-6, TNF-α, and CRP