ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Extent of facial nerve decompression at the geniculate ganglion and labyrinthine segment via transmastoid supralabyrinthine approach: cadaveric study.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo quantitatively assess the extent of facial nerve decompression achievable at thegeniculate ganglion and labyrinthine segment using the transmastoid supralabyrinthineapproach in cadaveric specimens.
methodsEleven formalin-fixed human cadaveric heads (22 temporal bones) underwentpreoperative high-resolution computed tomography (CT) to measure the lengths of thegeniculate ganglion and labyrinthine segment within their bony canals. A standardizedtransmastoid supralabyrinthine approach was then performed to decompress the facialnerve. Postoperative CT was used to determine the length of nerve segments successfully decompressed. Pre- and postoperative measurements were compared tocalculate the percentage of decompression achieved.
resultsComplete exposure of the geniculate ganglion was achieved in all specimens. Themean total length of the labyrinthine segment was 3.28 ± 0.80 mm. Followingdecompression, a mean length of 1.37 ± 0.84 mm of the labyrinthine segment wassuccessfully unroofed, corresponding to an average decompression of 40 ± 22%. Noinjury to the ossicular chain, semicircular canals, or labyrinth was observed onpostoperative CT imaging.
conclusionThe transmastoid supralabyrinthine approach enables safe, hearing-preservingdecompression of the geniculate ganglion and partial decompression of thelabyrinthine segment. Despite limited exposure of the labyrinthine segment, it mayserve as a feasible alternative in selected cases where more extensive approachesentail higher morbidity.
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