Successful treatment of highly recurrent facial baroparesis in a frequent high-altitude traveler: a case report.

BACKGROUND: Facial baroparesis is a palsy of the seventh cranial nerve resulting from increased pressure compressing the nerve along its course through the middle ear cavity. It is a rare condition, most commonly reported in barotraumatic environments, in particular scuba diving and high-altitude air travel. We report here an unusual case of highly frequent baroparesis, workup, and successful treatment. CASE PRESENTATION: A 57-year-old Caucasian male frequent commercial airline traveler presented with a 4-year history of recurrent episodes of right-sided facial paralysis and otalgia, increasing in both frequency and severity. Incidents occurred almost exclusively during rapid altitude changes in aircraft, mostly ascent, but also during rapid altitude change in an automobile. Self-treatment included nasal and oral decongestants, nasal corticosteroids, and warm packs. Temporal bone computed tomography (CT) scan revealed possible right-sided dehiscence of the tympanic bone segment; audiogram and magnetic resonance imaging of the internal auditory canals were unremarkable. After a diagnosis of facial nerve baroparesis was made, the patient underwent myringotomy with insertion of a pressure equalization tube (PET) into the right tympanic membrane. Despite re-exposure to altitude change multiple times weekly post-treatment, the patient reported being symptom-free for more than 6 months following intervention. CONCLUSIONS: Prompt PET insertion may represent the preferred treatment for individuals who suffer recurrent episodes of facial baroparesis. Education regarding this rare condition may prevent unnecessary testing and treatment of affected patients. Future studies should explore the pathophysiology and risk factors, compare therapeutic options, and provide follow-up data to optimize the management of affected patients.

Repetition-based credibility enhancement of unfamiliar faces.

This experiment demonstrated that rating the credibility of nonfamous faces results in a significant increase in rated credibility on a subsequent encounter relative to new nonfamous faces. The degree of credibility enhancement is comparable for both honesty and sincerity ratings and at both short (2-day) and long (14-day) interrating intervals. Furthermore, credibility enhancement was independent of recognition; ratings were significantly higher for repeated faces, regardless of whether they were remembered. Although female faces were rated more credible than male faces, there was no gender difference in the degree of credibility enhancement with repetition. Conditional analyses revealed that actual, rather than perceived, repetition formed the basis of credibility enhancement. Future research should compare repetition effects on both credibility and affect as well as the durability of such effects over time.