[Facial nerve identification in the translabyrinthine approach: an alternative method]

Area of Science:

• Neurosurgery
• Otolaryngology
• Cranial nerve surgery

Context:

• Acoustic neuromas require microsurgical dissection, prioritizing facial nerve preservation.
• The translabyrinthine approach necessitates accurate facial nerve identification at the internal auditory canal fundus.
• Current identification methods pose risks of nerve injury and are time-consuming.

Purpose:

• To present an alternative, safer, and more efficient method for identifying the facial nerve during translabyrinthine surgery.
• To reduce the potential for facial nerve injury, especially for less experienced surgeons.
• To streamline the surgical process for acoustic neuroma treatment.

Summary:

• An alternative technique involves transecting the superior ampullary nerve in the superior cribrosa area, away from the facial nerve.
• Medial reflection of the superior ampullary and superior vestibular nerves facilitates facial nerve identification.
• This method establishes a clear vestibulo-facial dissection plane for improved surgical outcomes.

Impact:

• Enhances facial nerve preservation during acoustic neuroma surgery.
• Improves surgical safety and efficiency in translabyrinthine approaches.
• Offers a valuable technique for neurosurgeons and otolaryngologists managing acoustic neuromas.