Bilateral facial paralysis is a rare condition. We present a case of acute myeloblastic leukemia manifesting itself in bilateral hearing loss and bilateral facial paralysis. We suspected systemic disease because of the abnormal blood cell count of the case. The diagnosis of leukemia was made with histological examination of a bone marrow aspirate. Computed tomography and gadolinium-enhanced magnetic resonance imaging scans revealed bilateral infiltration of the mastoid bones, middle ears and facial nerves. One should always remember that bilateral facial paralysis may be the first sign of a life-threatening illness. If infiltration is observed in the air-filled cells of the mastoid bone, before emergency surgery is planned, the possibility of leukemic infiltration should be considered.

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