J Korean Neurosurg Soc.  2001 Apr;30(4):479-485.

Facial Nerve Decompression via Middle Fossa Approach: Report of Three Cases

• Cho J
• Park SH
• Kim JY

Abstract

OBJECTIVE
Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. METHOD:Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus.
RESULTS
After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially.
CONCLUSION
This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

Keyword

Peripheral type facial paralysis; Facial nerve decompression; Middle fossa approach

MeSH Terms

Bell Palsy
Cranial Fossa, Middle
Decompression*
Decompression, Surgical
Facial Nerve*
Facial Paralysis
Geniculate Ganglion
Humans
Meningeal Arteries
Paralysis