Unknown in origin, Bell\'s palsy is a common acute facial nerve paralysis that is usually characterized by unilateral facial weakening or paralysis. People of all ages are affected by this illness, which peaks in the fourth decade of life. Although the precise etiology is yet unknown, viral infections - particularly type 1 herpes simplex virus - are frequently linked to the problem. Based on the evidence of abrupt onset facial weakness and the elimination of other neurological diseases, the diagnosis is essentially clinical. The goals of management techniques are to lessen related symptoms, encourage nerve regeneration, and lessen inflammation. Corticosteroids, antiviral drugs, physical therapy, and supportive measures are available as treatment alternatives. The majority of patients experience spontaneous recovery within weeks to months, and the prognosis is generally excellent. Nonetheless, a portion may experience long-term consequences, highlighting the significance of individualized follow-up care. Bell\'s palsy is succinctly summarized in this abstract to aid in better comprehension and well-informed clinical practice decision-making.

Chronic paralysis of the facial nerve leads to degenerative facial muscle and surrounding soft tissue alterations on the involved side, making the affected patients seem older than their actual age. Moreover, contralateral facial hypertrophy worsens facial asymmetry. Correction of the drooping or wrinkled face due to aging, trauma, or other pathology has been successfully treated with the thread-lifting technique. Here, we present the case report of a 23-year-old female patient suffering from oncologic post-surgery complications associated with chronic facial nerve paralysis. She also suffered from old and new cerebellar syndromes on the right side and lesions of the oculomotor, trochlear, and abducens nerves. Based on the patient history, the condition was treated under local anesthesia by the use of APTOS minimally invasive threads with barbs made from non-absorbable material. Correction and sculpting of the affected cheek area were performed by insertion of a light lift needle, and lifting of the superficial fat pads was secured by subdermal insertion of the light lift thread method. The jowl area was lifted by the superficial insertion of both types of threads. As a result, we significantly improved facial symmetry at rest, a more symmetric smile, a lifted corner of the mouth, and an anatomically sculpted cheek appearance.

UNASSIGNED: Cochlear implantation (CI) is a surgical intervention used to rehabilitate hearing in individuals, both pediatric and adult, with severe hearing loss. It is generally a safe procedure with rare postoperative complications. Facial nerve paralysis following cochlear implant surgery poses challenges in diagnosis and treatment.
UNASSIGNED: This case report details a 48-year-old male who experienced delayed facial paralysis after cochlear implantation, an uncommon occurrence with limited documentation.
UNASSIGNED: The facial nerve palsy of the patient resolved by the third week with combined therapy.
UNASSIGNED: The etiology of this complication is not fully understood, with latent virus reactivation, particularly HSV and VZV, hypothesized as a probable cause.
UNASSIGNED: Successful management involves a combination of corticosteroids, antiviral therapy, and antibiotics, leading to a favorable outcome.

Skull base osteomyelitis is a not commonly encountered but potentially fatal consequence of untreated necrotizing otitis externa. Early recognition and appropriate treatment are crucial to prevent serious complications such as cranial nerve palsies, meningitis, and intracranial abscess formation. The case reports presented in this study provide a rich depiction of the clinical presentation, diagnostic challenges, and interventions employed. Early recognition and appropriate management of skull base osteomyelitis are crucial to prevent complications and improve patient outcomes.

OBJECTIVE: To report 20 years of natural history data for a facial paraganglioma and provide a comprehensive review of the existing literature.
METHODS: 81-year-old female with a remote history of cardiac arrest while under anesthesia who elected to observe her facial paraganglioma for 20 years.
METHODS: Observation, clinical documentation, radiographic surveillance.
METHODS: Tumor progression, patient symptomatology, and review of management options.
RESULTS: The initial presentation of the facial paraganglioma was facial spasm. Over the course of observation, symptoms progressed to include complete facial nerve paralysis, pulsatile tinnitus, and otalgia on the affected side. Radiologic surveillance demonstrated incremental growth and erosion of surrounding structures, including the posterior external auditory canal, stylomastoid foramen, and lateral semicircular canal with near-dehiscence. Twenty-four cases of facial paraganglioma were identified in the extended literature search and are summarized herein.
CONCLUSIONS: This unique case contributes to the scarce literature surrounding facial paragangliomas by reporting the extended natural history of this disease.

Temporal bone injuries due to gunshot wounds are uncommon but devastating, with a high risk of damage to critical neurovascular structures. The high resistance of the temporal bone, the densest bone in the human body, can sometimes avoid a fatal outcome. However, the complications are in many cases devastating and include hearing loss, facial paralysis, cerebrospinal fluid leakage, intracranial damage, and vascular injuries. Our goal was to report a case of ballistic injury to the temporal bone and describe the surgical approach taken for treatment. A 74-year-old man was transferred to the emergency room of our tertiary hospital, intubated and sedated, after an attempted suicide with a firearm. The CT scan showed the metal projectile lodged within the temporal bone on the right side, with the destruction of the ossicular chain and bony labyrinth. After stabilization, sedation was reversed, and the otolaryngology team was called. On examination, the entry wound was located in the cavum concha, with no active bleeding but presenting active otorrhea of cerebrospinal fluid. The patient had complete peripheral facial paralysis on the right side and spontaneous horizontal nystagmus toward the left side. Empirical antibiotic therapy was initiated. A subtotal petrosectomy was performed, with the removal of the foreign body, repair of the cerebrospinal fluid fistula, obliteration of the cavity with abdominal fat, and closure of the external auditory canal. He was discharged on the 11th-day post-surgery, maintaining complete facial paralysis and right-side anacusis, but was able to walk with assistance. In conclusion, penetrating trauma of the temporal bone is a potentially life-threatening situation, and patients that survive have a guarded prognosis, as it often leads to permanent sequelae even when managed promptly.

Coronaviruses are important pathogens in humans and animals. Two years ago, a new coronavirus was identified as the cause of pneumonia and adult respiratory distress syndrome. These viruses have many clinical features, and new features are created daily. Bell\'s palsy is sporadic facial nerve palsy. The main reason of Bell\'s palsy is not recognized. Many viruses, such as herpes simplex or herpes zosters, have been previously identified as Bell\'s palsy. This case report seeks to explain the occurrence of Bell\'s palsy in a patient infected with coronavirus. The polymerase chain reaction test of a 60-year-old woman was positive for SARS-CoV-2. Bell\'s palsy happened on the 2nd day of admission to intensive care unit and recovered by the 12th day. After ruling out other etiologies of Bell\'s palsy, coronavirus appears to be one of the new etiologies of Bell\'s palsy.

Ramsay Hunt syndrome (RHS) with concomitant vocal cord paralysis (VCP) is a rare finding. This case is particularly rare because the patient lacked the symptoms of otalgia or hearing loss when in fact, a majority of cases typically demonstrate both hearing loss and otalgia. Unique to this case is also the fact that it was complicated by a concomitant infarction of the splenium corpus callosum and a right temporal meningioma. The purpose of this study was to bring awareness to the fact that RHS can cause multiple cranial nerve neuropathies including VCP and should be included in the differential diagnosis for VCP.

Bell\'s palsy is an acute, ipsilateral facial paralysis secondary to inflammation of cranial nerve VII. This condition is classically caused by herpes simplex virus (HSV); however, many providers will make a diagnosis in the setting of other underlying conditions that are known to cause similar symptoms. The annual incidence of Bell\'s palsy is 11.5-53.3 per 100,000 persons, with a small subset of individuals being contact sport athletes. A unique challenge to treating Bell\'s palsy in collegiate athletes is finding a way for these players to return to their sport in a timely fashion, while also avoiding traumatic ocular injuries. Athletic goggles may provide a potential alternative option for athletes to return to the play of their respective sport prior to the physical symptoms subsiding. Due to the prolonged duration of most Bell\'s palsy symptoms, athletic goggles have the ability to save up to a full season of eligibility for a player. Aside from ocular injuries, a further challenge which encompasses all cases of Bell\'s palsy is the negative psychosocial effects which accompany the physical symptoms of this condition. Both the patient\'s physical and psychosocial health considerations must be taken into consideration. In this case report, we review the utility of ocular protection in helping collegiate athletes with unilateral facial paralysis return to play prior to the resolution of symptoms.

Cranial nerve VII palsy is one of the most common cranial nerve pathologies seen in clinical practice. In the vast majority of cases, the cause is thought to be idiopathic and is also referred to as Bell\'s palsy. These cases are normally self-limiting and often treated with a short course of corticosteroids for symptom management. However, prompt work-up and diagnosis are crucial, as non-idiopathic causes can often be life-altering and necessitate prompt intervention. Here, we report a unique case of a 43-year-old immigrant male who presented to the emergency department with a three-day history of worsening facial droop and slurred speech, with associated facial pain, headaches, and dizziness for the previous week. On exam, there was stark right facial weakness involving both the upper and lower portions of the face with no sensory deficits. The patient\'s right eye was erythematous and painful, with no ability to fully open or close the right eyelid. The initial workup showed minor transaminitis with pancytopenia. A thorough workup was initiated, and all testing and serology were normal, with the exception of initial HIV screening. This was then followed by polymerase chain reaction (PCR) and viral load testing, which confirmed a new diagnosis of acute HIV infection presenting with unilateral CN VII palsy. In this report, we discuss the etiology, clinical features, differentials, and treatment options for facial nerve paralysis, along with the subtle connection to acute HIV infection.