Endoscopic Decompression of the Labyrinthine Segment of the Facial Nerve

Abstract

Objective: 

To describe the outcome and feasibility of an exclusive endoscopic transcanal transpromontorial approach (ETTA) for decompression of the labyrinthine segment of the facial nerve (LSFN).

Patient: 

A 60-year-old man with a left-sided transverse fracture of temporal bone involving the LSFN, resulting in a grade VI House–Brackmann (HB) facial palsy, associated with ipsilateral total sensorineural hearing loss.

Intervention: 

Surgical decompression of the LSFN by ETTA.

Main Outcome Measure: 

The patient underwent ETTA which allowed complete exposure and decompression of the LSFN.

Results: 

One year postoperatively, the patient had recovered with House–Brackmann grade II facial function.

Conclusion: 

ETTA can be considered a valuable and appropriate technique for posttraumatic decompression of LSFN, associated with unilateral total sensorineural hearing loss. The procedure resulted in significant facial nerve function improvement. ETTA should be considered both a scarless, mastoid conserving and less invasive surgical technique for posttraumatic LSFN decompression associated with pre-existing cochlear impairment.