Endoscopic Decompression of the Labyrinthine Segment of the Facial Nerve.

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.