The Learning Curve in Establishing Mastoid-Epitympanum Approach for Facial Nerve Decompression for Traumatic Facial Paralysis
SAI Na
WU Nan
SHEN Weidong
DAI Pu
YANG Shiming
HAN Dongyi
HAN Weiju
Abstract：Objective To report the authors'learning and practices experiences in developing facial nerve decompression treatment strategies for peripheral facial palsy resulting from temporal bone trauma via the mastoid-epitympanum approach.Methods Data from 31 patients(32 sides)with traumatic facial palsy treated from October 2019 to October 2024 at the Department of Otolaryngology,Head and Neck Surgery,PLA General Hospital were reviewed,including 21 males(22 sides)and 10 females(10 sides),aged from 4 to 70(29.8±18.4)years.The review focused on time required to master surgical techniques,anatomical variations and adverse events encountered during facial nerve decompression via the mastoid-epitympanum approach.Results Surgical time required for the mastoid-epitympanum approach was relatively long in the initial 12 cases,which decreased as the number of cases increased from 13 to 20 and stabilized for the 21st to 32nd procedures.Fibrous tissue hyperplasia along the fracture line,sigmoid sinus displacement,meningeal sagging,etc,obscured anatomical landmarks within the temporal bone in some cases,resulting in a constricted field and prolonged time to establish an appropriate surgical approach.Conclusion A solid foundation of middle ear microsurgery skills significantly facilitates acquisition of techniques necessary for establishing the mastoid-epitympanum approach.In clinical practice,it is essential to ensure appropriate selecting of indications and surgical approach,including critical techniques,to help minimize the occurrence of adverse surgical events.
Keywords：facial paralysisfacial nerve injuriesdecompressionlearning curve
Publication Date：2025-08-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 710-713 )