Trans-tensor tympani facial nerve decompression in traumatic facial nerve palsy.

OBJECTIVE

The surgical approaches previously reported for facial nerve decompression have focussed on achieving good exposure of the lateral or superior aspects of the geniculate ganglion. This report aims to describe a unique case of facial nerve decompression beneath the geniculate ganglion.

PATIENT: A 30-year-old woman with right-sided facial palsy due to a temporal bone fracture.

INTERVENTION: Bony fragments at the base of the geniculate ganglion were removed via a trans-tensor tympani approach with extended posterior tympanotomy.

RESULTS

The patient’s facial movement recovered successfully, without complications such as sensorineural hearing loss and conductive hearing loss.

CONCLUSION

In rare cases requiring decompression of the facial nerve inferior to the perigeniculate area, the trans-tensor tympani approach should be considered as a valuable alternative option when surgical intervention is considered.