European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
Extent of facial nerve decompression at the geniculate ganglion and labyrinthine segment via transmastoid supralabyrinthine approach: cadaveric study.
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Orhan Kadir Serkan, Sönmez Said, Özkan Ahmet, Alayoğlu Vedat Emre, Karakuş Cafer, Barburoğlu Mehmet, Yılmaz Polen, Çelik Mehmet, Polat Beldan, Güldiken Yahya
Аннотация
OBJECTIVE: To quantitatively assess the extent of facial nerve decompression achievable at thegeniculate ganglion and labyrinthine segment using the transmastoid supralabyrinthineapproach in cadaveric specimens.
METHODS: Eleven formalin-fixed human cadaveric heads (22 temporal bones) underwentpreoperative high-resolution computed tomography (CT) to measure the lengths of thegeniculate ganglion and labyrinthine segment within their bony canals. A standardizedtransmastoid supralabyrinthine approach was then performed to decompress the facialnerve. Postoperative CT was used to determine the length of nerve segments successfully decompressed. Pre- and postoperative measurements were compared tocalculate the percentage of decompression achieved.
RESULTS: Complete exposure of the geniculate ganglion was achieved in all specimens. Themean total length of the labyrinthine segment was 3.28 ± 0.80 mm. Followingdecompression, a mean length of 1.37 ± 0.84 mm of the labyrinthine segment wassuccessfully unroofed, corresponding to an average decompression of 40 ± 22%. Noinjury to the ossicular chain, semicircular canals, or labyrinth was observed onpostoperative CT imaging.
CONCLUSION: The transmastoid supralabyrinthine approach enables safe, hearing-preservingdecompression of the geniculate ganglion and partial decompression of thelabyrinthine segment. Despite limited exposure of the labyrinthine segment, it mayserve as a feasible alternative in selected cases where more extensive approachesentail higher morbidity.
METHODS: Eleven formalin-fixed human cadaveric heads (22 temporal bones) underwentpreoperative high-resolution computed tomography (CT) to measure the lengths of thegeniculate ganglion and labyrinthine segment within their bony canals. A standardizedtransmastoid supralabyrinthine approach was then performed to decompress the facialnerve. Postoperative CT was used to determine the length of nerve segments successfully decompressed. Pre- and postoperative measurements were compared tocalculate the percentage of decompression achieved.
RESULTS: Complete exposure of the geniculate ganglion was achieved in all specimens. Themean total length of the labyrinthine segment was 3.28 ± 0.80 mm. Followingdecompression, a mean length of 1.37 ± 0.84 mm of the labyrinthine segment wassuccessfully unroofed, corresponding to an average decompression of 40 ± 22%. Noinjury to the ossicular chain, semicircular canals, or labyrinth was observed onpostoperative CT imaging.
CONCLUSION: The transmastoid supralabyrinthine approach enables safe, hearing-preservingdecompression of the geniculate ganglion and partial decompression of thelabyrinthine segment. Despite limited exposure of the labyrinthine segment, it mayserve as a feasible alternative in selected cases where more extensive approachesentail higher morbidity.