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StatPearls
Book. 2017 06
Authors:
Abstract
Alternobaric facial paresis, facial baroparesis, baroparesis facialis, or alternobaric facial nerve palsy is a neurapraxia of the seventh cranial nerve due to pressure effects. The pressure in the middle ear can cause compression of the facial (seventh cranial) nerve against the tympanic promontory (cochlear promontory). Symptoms are similar to Bell's palsy. It occurs on ascent during airplane trips or with diving. Equalization of the middle ear pressure can make it disappear (yawning, swallowing, or a Toynbee maneuver). This pressure issue may also cause alternobaric vertigo. A causative relationship between middle-ear overpressure and facial palsy may be supported by the palsy's rapid onset when ambient pressure is reduced, as well as, its quick disappearance when ambient pressure increases or the middle ear overpressure releases. Divers experience a similar palsy, ischemic neurapraxia of the fifth cranial nerve, from compression in the maxillary sinus. Misdiagnosis as neurologic DCS or air embolism results in unnecessary recompression treatment and restriction of diving.
PMID: 29262056
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