Recurrent transient facial nerve palsy on commercial air flights

Facial baroparesis is a rare event, usually associated with a favourable outcome. It is related to atmospheric pressure changes that are responsible for neuropraxia. Most cases of facial baroparesis have been reported in the context of underwater diving, but very few cases have been reported during...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2021-05, Vol.138 (3), p.187-189
Main Authors: Le Carboulec, L., De Mestier, J., Boucenna, M., Lecanu, J.-B.
Format: Article
Language:English
Subjects:
Baroparesis
Commercial flight
Facial nerve canal dehiscence
Facial palsy
Otitis media with effusion
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Summary:Facial baroparesis is a rare event, usually associated with a favourable outcome. It is related to atmospheric pressure changes that are responsible for neuropraxia. Most cases of facial baroparesis have been reported in the context of underwater diving, but very few cases have been reported during commercial flights. We report the case of a patient who experienced several episodes of spontaneously resolving left facial palsy during long-haul flights. The work-up revealed bilateral facial nerve canal dehiscence visible on CT scan and clinical features of bilateral otitis media with effusion associated with hearing loss. The pathogenesis of this disease involves the combination of these two elements inducing ischaemia of the exposed facial nerve submitted to pressure variations. In most cases, ischaemia is rapidly reversible with complete recovery after landing or in response to Valsalva manoeuvres. It is therefore important not to miss this entity to avoid delayed or inappropriate management.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2020.09.009