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7. Jahrestagung der Deutschen Akademie für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.
3. und 4. Mai 2008, WCC Bonn (ehem. Bundeshaus) / Haus der GeschichteAbstracts zum Kursprogramm
Sonntag, 4. Mai 2008
12.00 – 13.45 Uhr
World Conference Center – Raum D
Kurs 60
Trans canal facial nerve decompression from meatal foramen to stylomastoid foramen
Kursleiter:
H. Vijayendra, Bangalore (Indien)
This Procedure is mainly indicated in cases of Longitudinal facture of Temporal Bone causing Facial Nerve Paralysis usually the lesion will be around perigeniculate ganglion and involving Labyrinthine segment, Second indication is for un-recovered Bell's Palsy.
Through post auricular approach after tympanotomy canalplasty done. Incus and Malleus head removed, using 3-0 diamond burr perform atticotomy to get good exposure of horizontal segment of facial nerve. Keep widening the meatal rim till you see the shadow of vertical segment of facial nerve upto stylomastoid foramen. Trace the horizontal segment from second genu to geniculate ganglion. Care is taken not to drill facial sheath. To expose the labyrinthine segment of the nerve, the supralabyrinthine air cells are drilled using 1-0 to 0.6 mm diamond burr. When you are nearer to the nerve, using 0/1-0 curette, rest of the Supra labyrinthine cells removed. Labyrinthine segment is devoid of epineurieum. Labyrinthine segment runs posterior and parallel to geniculate ganglion almost forming an acute angle.
It is exposed up to meatal foramen. Using tenotome and microscissors incise the sheath. Start incising the sheath retrogradely from stylomastoid foramen towards geniculate ganglion. Sheath opened like a book for 1800 up to the geniculate ganglion. This is a simple technique to decompress Labyrinthine segment compared to middle cranial fossa approach. Most of the cases are done under Local anaesthesia with excellent post - op facial Nerve recovery.
* Kurs zur Vorbereitung auf die Facharztprüfung
