Which symptom is associated with Bell's palsy due to paralysis of the stapedius muscle?

• A. Hyperacusis
• B. Tinnitus
• C. Hearing loss in the opposite ear
• D. Dizziness

Answer: (A)

The key idea is that the stapedius muscle dampens loud sounds to protect the inner ear. When Bell's palsy affects the facial nerve, the branch that innervates the stapedius can be knocked out, removing that protective dampening. Without the stapedius reflex, sounds become exaggeratedly loud on the affected side, a condition called hyperacusis. This is why hyperacusis is the best fit for a symptom caused by paralysis of the stapedius.

Tinnitus is a subjective ringing or buzzing not specifically caused by stapedius paralysis, and hearing loss in the opposite ear and dizziness don’t follow from unilateral stapedius weakness.