Book chapter
173 - Intratemporal Facial Nerve Surgery
Cummings Otolaryngology, pp.2598-2610.e1
Elsevier Inc, Seventh Edition
2021
Abstract
Objectives: To discuss the surgical approaches to the facial nerve, including the technical nuances, surgical anatomy, and the advantages and disadvantages of each.
Design: Review of the literature and author expertise are highlighted to discuss the retrosigmoid, retrolabyrinthine, middle fossa, translabyrinthine, and combined approaches to the facial nerve.
Results: The retrosigmoid and retrolabyrinthine approaches provide access to the brainstem and cisternal segments of the facial nerve. The middle fossa approach allows decompression of the labyrinthine and tympanic segments with hearing preservation, whereas the translabyrinthine approach allows access to the entire intratemporal facial nerve but does not preserve hearing. For patients with severe Bell palsy, with more than 90% degeneration on electroneuronography (EnoG) and no voluntary motor unit potentials, the middle cranial fossa (MCF) approach for decompression within 2 weeks of onset results in high rates of facial nerve recovery to House-Brackmann (HB) Grade I or II function as compared with steroids alone (92% vs 42%).
Conclusions: Appropriate management of facial nerve disorders requires a thorough knowledge of the pathophysiology of diseases that affect the facial nerve, experience in the interpretation of findings on radiologic and electrophysiologic tests of the nerve, and expertise in multiple neurotologic surgical approaches to the facial nerve.
Details
- Title: Subtitle
- 173 - Intratemporal Facial Nerve Surgery
- Creators
- Rick F. NelsonSamuel P. GubbelsBruce J. Gantz
- Resource Type
- Book chapter
- Publication Details
- Cummings Otolaryngology, pp.2598-2610.e1
- Edition
- Seventh Edition
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 2021
- Academic Unit
- Neurosurgery; Otolaryngology
- Record Identifier
- 9984304976302771
Metrics
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