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Updated: Nov 20, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Endoscopic Decompression of the Labyrinthine Segment of the Facial Nerve
Nicolas Cornu1,2, Daniele Marchioni3, Michael Eliezer4
1Otorhinolaryngology Department- Head and Neck surgery, Lariboisière Hospital, Paris, France.
Objective:
To describe the outcome and feasibility of an exclusive endoscopic transcanal transpromontorial approach (ETTA) for decompression of the labyrinthine segment of the facial nerve (LSFN).
Patient:
A 60-year-old man with a left-sided transverse fracture of temporal bone involving the LSFN, resulting in a grade VI House-Brackmann (HB) facial palsy, associated with ipsilateral total sensorineural hearing loss.
Intervention:
Surgical decompression of the LSFN by ETTA.
Main Outcome Measure:
The patient underwent ETTA which allowed complete exposure and decompression of the LSFN.
Results:
One year postoperatively, the patient had recovered with House-Brackmann grade II facial function.
Conclusion:
ETTA can be considered a valuable and appropriate technique for posttraumatic decompression of LSFN, associated with unilateral total sensorineural hearing loss. The procedure resulted in significant facial nerve function improvement. ETTA should be considered both a scarless, mastoid conserving and less invasive surgical technique for posttraumatic LSFN decompression associated with pre-existing cochlear impairment.
