Unilateral Temporal Bone Fracture with Traumatic Bilateral Facial Nerve Palsy

Abstract

Bilateral traumatic facial nerve paralysis rarely occurs. Unlike unilateral facial nerve paralysis, bilateral facial nerve paralysis is difficult to diagnose and sometimes missed due to lack of facial asymmetry. Evidence of temporal bone fracture on imaging with high index of suspicion will lead to a thorough physical examination to accurately diagnose a bilateral facial nerve paralysis. We reported a case of a 32-year-old lady who had traumatic bilateral facial nerve paralysis after a motor vehicle accident. Computed tomography scan showed a left temporal bone fracture involving facial canal with no evidence of fracture on contralateral side. The dilemma in managing a complex traumatic facial nerve palsy, the decision of surgery, timing and the successful result of the surgery are discussed.