Supraganglionärer Verlauf des Nervus facialis durch Warzenfortsatz und Epitympanum; eine bisher nicht beobachtete Anomalie

Summary

In a boy of 10 with primary cholesteatoma of the right ear the following anomaly of the facial nerve was demonstrated: The nerve enters the mastoid posteriorly to the labyrinth, approximately in the angle formed by superior and posterior canal, there it makes a right-angles turn forward and runs in a horizontal, slightly upward direction through mastoid and antram, crossing the lateral canal, via the epitympanum in close association to body of incus and head of malleus, in which it had moulded a groove. It leaves the epitympanum superiorly to the processus cochleariformis, and joins the geniculate ganglion; from there completely normal course in tympanic and mastoid portion of fallopian canal. The mastoid was fairly well pneumatized, the celles partly destroyed by cholesteatoma. The ossicular chain was intact. The nerve could be preserved. Its identy was confirmed by electric stimulation.

There were no other anomalies. The embryologic, forensic and surgical aspects of this anomaly are discussed.