PMC7563085_01
(a) Bilateral Charles Bell's phenomenon with mask-like face. (b) Left ear hemotympanum. (c) Left abducens palsy.
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A bilateral Charles Bell's phenomenon was noted, as well as an abduction deficit on the left eye (Figures 1(a) and 1(c)). Otoscopy revealed bilateral hemotympanum (Figure 1(b)).
Transverse section of cranial CT (plane of incudomalleolar joint) showing right longitudinal otic-sparing temporal bone fracture (yellow arrows) and left transverse temporal bone fracture (red arrows).
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High-resolution computed tomography (HRCT) showed an otic-sparing longitudinal right temporal bone fractures and a transversal left temporal bone fracture (Figure 2).
(a) Two-week follow-up: improvement of the right-side facial palsy. (b) Two-month follow-up: development of the mouth movement exhibiting the progressive return of function of the lower branches of the facial nerve. (c) Two-month follow-up: recovery of the left abducens palsy. (d) Six-month follow-up: evolution of the bilateral facial paralysis.
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At the two-week follow-up, after the stabilization of the patient, we noticed a remarkable improvement concerning the right side of the facial palsy, becoming a grade 2 H-B (Figure 3)(a), which encouraged to pursue with the conservative approach. Six months after the accident, the patient exhibited H-B grade 1 recovery on the right and H-B grade 2 recovery on the left side (Figure 3)(d).