Bilateral traumatic delayed facial nerve palsies: Challenges in management

Trauma causing bilateral temporal bone fracture has a unique mechanism. The type of fracture can predict the probability of facial nerve palsy. Commonly facial nerve palsy is managed by surgery or conservative management, depending on the onset, grading, and value of the objective electrodiagnostic test. The dilemma arises in our case when the young patient presented with delayed onset, bilateral incomplete facial nerve palsy, whereby the symmetrical monotonous looking can be misleading at initial diagnosis. We discussed several options of test available to give the prognostic value in the case if there is no normal side to be compared to.