Related Experiment Video
Updated: May 2, 2026

Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Anomalous facial nerve in congenital stapes fixation
Yun Suk An1, Jeong Hyun Lee, Kwang-Sun Lee
1*Department of Otolaryngology, and †Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Objective:
The aim of this article was to assess the prevalence and influence of anomalous facial nerves in patients undergoing surgery for congenital stapes anomalies.
Patients:
The medical records of all patients who underwent surgery for congenital stapes fixation between January 1999 and December 2012 were retrospectively reviewed. An abnormal facial nerve was found in 7 ears in 5 patients (from a total of 62 ears).
Main Outcome Measures:
The patients' temporal bone computed tomography results, operation records, video clips, and preoperative and postoperative hearing tests were reviewed.
Results:
Oval window atresia was found in all 7 ears, and the facial nerves in all 7 ears ran inferior medially over the atretic oval window niche. The atretic plate was fenestrated into the vestibule in the superior margin of the facial nerve. A piston wire was anchored to the long process of the incus in 3 ears, to the handle of the malleus in 3 ears, and attached to the tympanic membrane in 1 ear. The postoperative ABG at long-term follow-up was 13.1 dB (SD, 4.6 dB; range, 8.8-18.3 dB). No patient had postoperative facial weakness.
Conclusion:
An anomalous facial nerve was found in 11.2% of ears in patients undergoing surgery for congenital stapes fixation. Despite the anomalous course of facial nerves in these patients, vestibular fenestration was successful without facial nerve damage. The audiometric outcome at long-term follow-up was serviceable hearing for all cases.
Related Concept Videos
The Auditory Ossicles
The aptly named stapes look very much like a stirrup. The three ossicles are unique to mammals, and each plays a role in...
Prosopagnosia
Cranial Nerves: Types Part I
Olfactory Nerve (Cranial Nerve I)
The olfactory nerve, or cranial nerve I, is unique as it is purely sensory and dedicated to the sense of smell. This nerve originates in the olfactory epithelium of the...
Olfactory Receptors: Location and Structure
Anatomy of the Ear

