Extended Epitympanotomy for Facial Nerve Decompression as a Minimally Invasive Approach
Open Access
- 10 October 2019
- journal article
- research article
- Published by The Korean Audiological Society in Journal of Audiology & Otology
- Vol. 23 (4), 204-209
- https://doi.org/10.7874/jao.2019.00010
Abstract
For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.Keywords
Funding Information
- National Research Foundation of Korea (2016R1D1A1B01014128)
- Korea government
This publication has 15 references indexed in Scilit:
- Endoscopic Management of Attic CholesteatomaOtolaryngologic Clinics of North America, 2016
- How to Avoid Facial Nerve Injury in Mastoidectomy?Journal of Audiology & Otology, 2016
- Long-term Outcomes After Middle Fossa Approach for Traumatic Facial Nerve ParalysisOtology & Neurotology, 2016
- Management of epi- and mesotympanic cholesteatomas by one-stage trans-canal atticotomy in adultsEuropean Archives of Oto-Rhino-Laryngology, 2016
- Temporal Lobe Retraction Provides Better Surgical Exposure of the Peri-Geniculate Ganglion for Facial Nerve Decompression via Transmastoid ApproachYonsei Medical Journal, 2016
- Management of facial palsy after temporal bone fracture via the transmastoid approachActa Oto-Laryngologica, 2015
- Temporal Bone Fractures: Otic Capsule Sparing versus Otic Capsule Violating Clinical and Radiographic ConsiderationsThe Journal of Trauma and Acute Care Surgery, 1999
- Tensor fold and anterior epitympanum.1997
- Temporal Bone Fractures Inducing Facial Nerve Paralysis: A New Classification and Its Clinical SignificanceEar, Nose & Throat Journal, 1997
- Ear Surgery and Mastoid Air Cell SystemJAMA Otolaryngology–Head & Neck Surgery, 1981