Total facial nerve exploration: transmastoid, extralabyrinthine, and subtemporal indications and results

Increasingly, surgeons are using a middle fossa approach though craniotomy to reach the labyrinthine segment of the facial nerve and geniculate ganglion in patients with intact hearing. This paper describes a transmastoid operation that provide exposure of the labyrinthine segment of the facial nerve without performance of a craniotomy. In this procedure the geniculate ganglion and labyrinthine segments of the facial nerve were exposed, while cochleovestibular function was spared; recovery of the facial nerve in patients with Bell's palsy or herpes zoster oticus (even the patients with a dry eye) was favourably influenced.