Bilateral facial nerve paralysis in wegener's granulomatosis: A case report

Wegener's granulomatosis (WG) is a systemic inflammatory disease that typically presents with renal, pulmonary, and head and neck manifestations. Seventy-five percent of WG patients present with head and neck signs or symptoms, and approximately 90% of patients with WG will have ENT involvement during the disease course. Unilateral facial nerve paralysis occurs in approximately 5% of WG cases. We present a rare instance of bilateral facial nerve paralysis. The clinical notes and operative reports of a patient with WG were reviewed. Relevant literature was reviewed. This case reinforces the importance of medical intervention of WG that includes both high dose steroids and an immunosuppressive agent. It also serves as a reminder for the otolaryngologist that facial nerve paralysis should heighten awareness for WG, as earlier intervention can result in better overall outcomes for patients with WG.