Recurrent facial palsy: A CARE case report - 28/09/24

Doi : 10.1016/j.anorl.2024.03.006

A. Ferney ^a, J. Menager ^b, S. Schmerber ^a,^c,^e, R. Quatre ^a,^c,^d,^e,^⁎
^a Service d’oto-rhino-laryngologie et de chirurgie cervicofaciale, Centre hospitalo-universitaire Grenoble Alpes, BP 217, 38043 Grenoble cedex 09, France
^b Service d’anatomopathologie, Centre hospitalo-universitaire Grenoble Alpes, BP 217, 38043 Grenoble cedex 09, France
^c BrainTech Lab INSERM UMR 2015, Grenoble, France
^d GeodAIsics, Grenoble, France
^e Faculté de médecine, Université Grenoble Alpes, Domaine de la Merci, BP 170 La Tronche, 38042 Grenoble cedex 9, France

^⁎Corresponding author.

Abstract

Introduction

Middle-ear adenoma is a rare benign endocrine tumor with slow progression, and can, in very rare cases, lead to recurrent peripheral facial palsy.

Case report

A young man experienced three episodes of right peripheral facial palsy of incremental intensity, suggestive of barotrauma. CT and MRI found a tissue mass in the tympanic cavity, and biopsy diagnosed middle-ear adenoma. Electroneuromyography found 50% impairment of facial function. Closed right tympanoplasty with complete tumor resection enabled complete recovery of facial function within 1 month.

Discussion

Middle-ear adenoma is diagnosed on histology, as imaging on MRI can be non-specific, mimicking chronic otitis. Facial involvement is rare and is due to edematous compression of the vasa nervorum. Treatment is surgical, and follow-up should be prolonged. Palsy assessment on electroneuromyography indicates the urgency of treatment.

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Keywords : Peripheral facial palsy, Middle-ear adenoma, Barotrauma