Microsurgical Anatomy of the Perigeniculate Ganglion Area as Seen from the Middle Cranial Fossa Approach

Abstract

The middle cranial fossa approach is useful for decompressing the perigeniculate ganglion area of the facial nerve in patients with serviceable hearing. The present study was designed to investigate the microsurgical anatomy of the perigeniculate ganglion area of the facial nerve from the point of view of the middle cranial fossa. We dissected 20 human temporal bones under a microscope using a middle fossa approach, and measured the angle between the lines drawn from the malleus head to the vertical crest and from the malleus head to the geniculate ganglion, and the distance from the malleus head to the geniculate ganglion. These were found to be 22.7° ± 2.2° and 6.5 ± 0.3 mm, respectively. Detailed knowledge about the microsurgical anatomy of the perigeniculate ganglion area of the facial nerve from the point of view of the middle cranial fossa is imperative for facial nerve decompression by a middle cranial fossa approach.

Keywords

anatomy facial nerve microsurgery middle cranial fossa approach

Get full access to this article

View all access options for this article.

References

Gacek

. Surgical landmark for the facial nerve in the epitympanum. Ann Otol Rhinol Laryngol 1980; 89:249–50.

Proctor

Nager

. The facial canal: Normal anatomy, variations and anomalies. I. Normal anatomy of the facial canal. Ann Otol Rhinol Laryngol (Suppl) 1982; 91(suppl 97):33–44.

Nager

Proctor

. The facial canal: Normal anatomy, variations and anomalies. II. Anatomical variations and anomalies involving the facial canal. Ann Otol Rhinol Laryngol Suppl 1982; 91(suppl 97):45–61.

May

. Anatomy of the facial nerve for the clinician. In: May

, ed. The facial nerve. New York, NY: Thieme, 1986:21–62.

May

. Microanatomy and pathophysiology of the facial nerve. In: May

, ed. The facial nerve. New York, NY: Thieme, 1986:63–74.

Pulec

. The facial nerve: How to find it. Ear Nose Throat J 1993; 72:677–85.

Proctor

. The anatomy of the facial nerve. Otolaryngol Clin North Am 1991; 24:479–504.

Catalano

Eden

. An external reference to identify the internal auditory canal in middle fossa surgery. Otolaryngol Head Neck Surg 1993; 108:111–6.

Lee

H-K

Lee

E-H

Lee

W-S

Kim

. Microsurgical anatomy of the perigeniculate ganglion area as seen from a translabyrinthine approach. Ann Otol Rhinol Laryngol 2000; 109:255–7.

10.

House

. Surgical exposure of the internal auditory canal and its contents through the middle cranial fossa. Laryngoscope 1961; 71:1363–85.

11.

Fisch

. Transtemporal surgery of the internal auditory canal. Report of 92 cases, technique, indications and results. Adv Otorhinolaryngol 1970; 17:203–40.

12.

Garcia-Ibanez

. Middle fossa vestibular neurectomy: A report of 373 cases. Otolaryngol Head Neck Surg 1980; 88:486–90.