Facial nerve palsy: an atypical sign of glomus jugulare tumour recurrence.

We present a rare case of recurrent glomus jugulare tumour, manifesting as an isolated facial nerve palsy. Glomus jugulare tumours are slow-growing paragangliomas of the jugular bulb adventitia. We report the case of a 73-year-old female referred for oculoplastic management of a facial nerve palsy, with a history of a right-sided glomus jugulare tumour treated surgically 40 years prior. Her 6-month history of facial palsy had initially been attributed towards Bell's palsy, particularly in the context of communication challenges related to residual dysphonia and hearing loss following her prior skull-base surgery. This case underscores the importance of maintaining a high index of suspicion in patients with atypical or high-risk clinical features and highlights the necessity of timely neuroimaging to exclude underlying structural pathology.