I read the article by deAlmeida and colleagues1 and found it very informative. It is generally accepted that most cases of Bell palsy are related to virus-induced inflammation of the facial nerve; however, there are a few cases which are related to acute otitis media, which is often bacterial.2 As an anesthetist, I have seen situations where urgent myringotomy brought about rapid resolution of early Bell palsy. I mention this to remind the front-line physician that such a situation is possible.