Eckermann J, et al. - Utilizing the databases of PubMed, Scopus and Cochrane Library, researchers sought to concentrate on the etiology, incidence, and therapy of delayed paralysis of the facial nerve (DFP) following different types of middle ear surgery. Reporting studies from adult patients and DFP onset after 48 h after surgery have been involved. Using median, simple sum and statistical significance, data were analyzed with descriptive statistics. This review could include ten studies having 12,161 individuals. After the middle ear surgeries, the incidence of DFP differs between 0.2 and 1.9%. Patients with facial canal dehiscence have a significantly higher chance of getting a DFP. Overall, the prognosis of DFP is very good with mostly complete healing with appropriate therapy. The most favored genesis of DFP is viral reactivation. For those patients at risk for viral reactivation, immunization or antiviral prophylaxis is recommended.