Abstract
Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB) facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT) examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.
Highlights
Facial paralysis is fairly commonly encountered by ear, nose, and throat physicians, bilateral facial paralysis is very rare
We present 40-year-old male patient with bilateral facial paralysis caused by blunt head trauma
Bilateral facial paralysis caused by bitemporal bone fracture is very rare, with seven cases reported to date (Table 1)
Summary
Facial paralysis is fairly commonly encountered by ear, nose, and throat physicians, bilateral facial paralysis is very rare. The frequency of facial paralysis is 20–25 per 100,000 patients, but simultaneous bilateral facial paralysis occurs in only 1 in 5 million patients [1]. Simultaneous bilateral facial paralysis is considered present if the time elapsed from paralysis of one side to paralysis of the other side does not exceed 4 weeks [1]. A differential diagnosis of bilateral facial paralysis must consider systematic, traumatic, neuromuscular, vascular, toxic, and infectious diseases and idiopathic causes
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