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Surgical anatomy of the facial nerve: from middle cranial fossa approach to endoscopic approach. A pictorial review

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The pathology of the facial nerve is extremely varied and extensive knowledge of the surgical anatomy in different approaches is required to manage it. During the last 15 years, the development of endoscopic ear surgery has significantly changed anatomical concepts, introducing new surgical approaches. The aim of this review is to illustrate five different surgical approaches to the facial nerve: the endoscopic approach, the middle cranial fossa approach, two translabyrinthine approaches (one simple and one endoscopic-assisted) with decompression of the whole petrous portion of the facial nerve, and a transotic approach with temporal craniotomy.

Methods

Representative cases of middle and/or inner ear pathologies, surgically treated at our ENT Department, were selected to illustrate each of the five different approaches involving the facial nerve throughout its course.

Results

In all cases, the pathology was removed with effective decompression of the facial nerve. The surgical anatomy in each surgical approach is described and illustrated.

Conclusions

Facial nerve surgery is challenging for ENT specialists. An excellent knowledge of facial nerve anatomy is needed to eradicate pathology, avoiding nerve injuries and providing a good outcome after surgery.

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Acknowledgements

The language has been edited by Colin Woodham (Alpha Science Editors).

Funding

None were declared.

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Authors and Affiliations

  1. Otolaryngology Department, University Hospital of Verona, Verona, Italy

    Davide Soloperto, Flavia Di Maro, Beatrice Le Pera & Daniele Marchioni

Authors
  1. Davide Soloperto
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  2. Flavia Di Maro
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  3. Beatrice Le Pera
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  4. Daniele Marchioni
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Corresponding author

Correspondence to Beatrice Le Pera.

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Soloperto, D., Di Maro, F., Le Pera, B. et al. Surgical anatomy of the facial nerve: from middle cranial fossa approach to endoscopic approach. A pictorial review. Eur Arch Otorhinolaryngol 277, 1315–1326 (2020). https://doi.org/10.1007/s00405-020-05841-y

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  • DOI: https://doi.org/10.1007/s00405-020-05841-y

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