TODAY IT is surgically possible to expose the facial nerve from the brain stem to its terminal branches in the face. Previously, the most inaccessible area was the internal auditory canal and labyrinthine portion. This paper presents two surgical approaches to this portion of the facial nerve.
Use of Approaches
We have found these approaches to be of value in decompression of the facial nerve for Ramsey-Hunt syndrome, fractures, extensive cholesteatomas (congenital and acquired), and tumors. It has also been suggested as an approach for repair of the facial nerve following posterior fossa removal of eighth-nerve tumors.The middle cranial fossa approach has been used when the hearing was to be saved. Many fractures of the temporal bone cause hearing impairment as well as facial paralysis. Extensive cholesteatomas may also cause these symptoms. In cases where the restoration or preservation of residual hearing is not a factor, a translabyrinthine exposure