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Key methods of identifying the horizontal facial nerve during difficult middle-ear surgery

Published online by Cambridge University Press:  04 February 2013

M I Syed ,
M Madurska  and
B F O'Reilly
M I Syed*
Affiliation:
Department of Otolaryngology, Raigmore Hospital, Inverness, Scotland, UK
M Madurska
Affiliation:
Department of Otolaryngology, Raigmore Hospital, Inverness, Scotland, UK
B F O'Reilly
Affiliation:
Department of Otolaryngology, Gartnavel General Hospital, Glasgow, Scotland, UK
*
Address for correspondence: Mr M I Syed, Department of Otolaryngology, Raigmore Hospital, Inverness IV2 3UJ, Scotland, UK E-mail: [email protected]
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Abstract

Background:

The key to avoiding damage to the horizontal facial nerve in middle-ear surgery is to formally identify the nerve in the early stages of the procedure.

Methods:

In the non-infected ear this can be achieved relatively easily by identifying the oval window niche. However, in the infected ear with cholesteatoma, the safest landmark to use is the processus cochleariformis, which can be identified by three different methods.

Conclusion:

In an infected ear that is full of granulation tissue and/or cholesteatoma, the horizontal facial nerve can be reliably identified by locating the processus cochleariformis using the three methods described. This avoids damage to the nerve and important structures around it.

Keywords

MastoidectomyFacial NerveAnatomyMiddle Ear
Type
Short Communication
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 3 , March 2013 , pp. 303 - 305
Copyright
Copyright © JLO (1984) Limited 2013

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