A bifid intra-tympanic facial nerve in association with a normal stapes.
A rare facial nerve anomaly was incidentally discovered whilst performing a tympanoplasty and ossicular reconstruction on a patient with an acquired unilateral conductive hearing loss. The nerve was seen to bifurcate and straddle a normal stapes superstructure as it ran posteriorly through the middle ear, a unique and as yet unreported combination. This case highlights the importance of vigilance regarding facial nerve anatomical variations encountered during middle-ear surgery thus avoiding inadvertent damage. The purported embryological mechanism responsible for such anomalies of the intra-tympanic facial nerve is discussed.
Ahmed
J
J
Department of Otolaryngology, Charing Cross Hospital, London, UK. jayahmed11@hotmail.com
Chatrath
P
P
Harcourt
J
J
D005154:Facial Nerve / Q000002:abnormalities*; D034381:Hearing Loss / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013199:Stapes / Q000033:anatomy & histology*; D014432:Tympanic Membrane / Q000473:pathology*; D014433:Tympanoplasty