![]() ![]() However, the facial weakness in the right side persisted, so attended our outpatient department. During descent of the flight, she felt little comfortable and leading to near complete resolution of the symptoms. ![]() The patient vitals such as blood pressure, pulse rate, and respiratory rate were within normal limits. The flight attendant helped with mid-air emergency service. During maximum elevation, she felt tingling sensation on the right side of the face and felt numbness over the face along with mild headache. She had increased sensation of pressure in his ears during ascent of the flight, but failed to relieve even after doing yawning or chewing gum or Valsalva. He had a history of travel through flight where she developed facial weakness. We report a case of baroparesis in 38-year-old female who developed transient facial nerve paralysis while travelling on a commercial flight.Ī 38-year-old female attended the outpatient department of the Otorhinolaryngology with right side facial weakness since 3 days. The facial nerve palsy can be relieved by equalizing the pressure in the middle ear cavity through nasopharynx through eustachian tube. The development of the high pressure in the tympanic segment of the facial nerve may cause temporary ischemic neuropraxia which is thought to be the cause of the facial nerve palsy. This fallopian canal is a complicated bony pathway which is affected by the pressure changes. The facial nerve passes through the temporal bone via fallopian canal. There are certain conditions which narrows the lumen of the eustachian tube such as edema, raised viscosity of the mucus coating of the tubal mucosal membrane or impairment of the tube to open. This may be due to impaired function of the eustachian tube. It is often reported in pilots or divers due to development of the high pressure in middle ear cavity. Here, we report a case of a 38-year-old female who experiences unilateral facial nerve paralysis on ascent to high altitude on a flight, with relieve from symptoms shortly after descent.įacial baroparesis is facial nerve palsy due to transient hypoxemia of the seventh cranial nerve secondary to raised pressure in the middle ear cavity. The clinical history and imaging help to diagnose this rare cause of facial nerve paralysis. The overpressure in the middle ear cavity due to eustachian dysfunction may cause exertion of the excessive pressure over the facial nerve through a dehiscence of the horizontal segment of the fallopian canal leading to facial nerve paralysis. It is rarely reported in medical literature which can happen among persons those ascend to high altitude in flight or scuba diving. Given the increased prevalence of OSA, it is important to understand the risks associated with CPAP therapy.īarotrauma cochlear aqueduct continuous positive airway pressure ear–middle eustachian tube hearing loss hearing loss–sensorineural hearing loss–sudden sleep apnea–obstructive.Facial baroparesis is an extremely rare clinical entity which occurs due to otitic barotraumas. Many studies describe an increase in middle ear pressure with the use of CPAP, but few describe the effects of this increased pressure on the middle ear, such as the otic barotrauma described in this case. While the benefits of CPAP are clear, we must take into account the rare but possible effects on ear structure and function. We also discuss the pathophysiology of otic barotrauma and present a review of current literature on the topic. We describe the detailed clinical course and outcome for a patient with otic barotrauma as a result of excessive self-titration of CPAP therapy in an in-home setting. While using CPAP devices may lead to many adverse effects, the majority of these effects are described as relatively benign. Subsequently, there has been an ever-increasing rise in the use of continuous positive airway pressure (CPAP) devices. The prevalence of OSA has risen drastically in the past few decades concurrently with the increasing prevalence of obesity. Obstructive sleep apnea (OSA) is a growing problem affecting millions of people in the United States. ![]()
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