Intratemporal facial nerve anastomosis: a temporal bone study.

The temporal bone findings in a patient who suffered a transverse temporal bone fracture and subsequently underwent intratemporal facial nerve anastomosis are presented. The patient returned a year after surgery with otorrhea and partial return of facial function that was documented clinically, and by electromyograph 12 days before death. The temporal bone shows breakdown of the posterior external canal wall and infection of the surgical cavity. At the facial nerve anastomosis, there is a fibrosis and lack of myelination in the few regenerating nerve fibers. These results demonstrate a seldom-mentioned complication of the translabyrinthine approach, and suggest changes in the technique of facial nerve anastomosis to improve the results.