Conclusion: The surgical procedure for the superior prelabyrinthine cell tract approach is described in detail. This approach is a safer and less invasive procedure to totally decompress the facial nerve compared with conventional middle fossa approach.
Objective: To develop a new approach to the meatal and labyrinthine segments that does not require a craniotomy.
Background: If performed within 2 weeks after the onset of facial palsy, total decompression of the facial nerve enhances the chance of normal or near-normal facial function recovery in cases with massive nerve degeneration. The transmastoid approach and middle fossa approach are usually combined to totally expose the intratemporal facial nerve. However, the middle fossa approach requires a craniotomy in the temporoparietal area. Because of its invasiveness, patients often hesitate to consent to this operation, and as a result the recovery from facial palsy is incomplete.
Surgical Procedure: The meatal and labyrinthine segments of the facial nerve are exposed by the superior route via the superior prelabyrinthine cell tracts. Partial resection of the zygoma makes this approach feasible.
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