# An Effective Treatment for Recurrent Bilateral Facial Palsy in a Flight Attendant: A Case Report

## TL;DR

A flight attendant with a rare facial nerve condition was successfully treated with Eustachian tube dilatation and grommet insertion.

## Contribution

This case report presents a successful treatment approach for recurrent bilateral facial baroparesis.

## Key findings

- The patient's symptoms resolved after bilateral Eustachian tube dilatation and grommet insertion.
- HRCT scan identified dehiscence in the facial canal wall.
- Conservative treatments like antihistamines and decongestants were ineffective.

## Abstract

Recurrent facial baroparesis is a rare condition that is mostly observed in individuals who have been exposed to barotraumatic conditions, particularly scuba divers and air travelers. We present a case of an unusual bilateral alternating recurrent facial nerve palsy and its successful treatment. A 34-year-old airline stewardess presented with a seven-month history of recurrent bilateral alternating facial nerve palsy that occurred exclusively during airline takeoffs. A clinical diagnosis of facial baroparesis was made. The temporal bone’s high-resolution CT (HRCT) scan revealed a bilateral tympanic segment of the facial canal wall dehiscence. Conservative treatment with oral antihistamines and nasal decongestants proved ineffective in treating this unusual condition. The patient then underwent bilateral Eustachian tube dilatation as well as bilateral myringotomy and grommet insertion. Post-treatment, she became asymptomatic despite multiple re-exposure to high-altitude travel. With our successful reported case of this uncommon recurrent condition, Eustachian tube dilatation as well as myringotomy and grommet insertion could potentially become the standard approach to treatment.