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Updated: May 8, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Trans-tensor tympani facial nerve decompression in traumatic facial nerve palsy
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Objective:
The surgical approaches previously reported for facial nerve decompression have focussed on achieving good exposure of the lateral or superior aspects of the geniculate ganglion. This report aims to describe a unique case of facial nerve decompression beneath the geniculate ganglion.
Patient:
A 30-year-old woman with right-sided facial palsy due to a temporal bone fracture.
Intervention:
Bony fragments at the base of the geniculate ganglion were removed via a trans-tensor tympani approach with extended posterior tympanotomy.
Results:
The patient’s facial movement recovered successfully, without complications such as sensorineural hearing loss and conductive hearing loss.
Conclusion:
In rare cases requiring decompression of the facial nerve inferior to the perigeniculate area, the trans-tensor tympani approach should be considered as a valuable alternative option when surgical intervention is considered.
