Zygomatic root approach.
CONCLUSIONS
The zygomatic root (ZR) approach provides improved intraoperative exposure of the key areas around the geniculate ganglion without a craniotomy, combining the advantages of middle cranial fossa (MCF) and transmastoid extralabyrinthine (TMEL) approaches. The ZR approach may be useful in cases of traumatic facial palsy, Bell's palsy, iatrogenic facial palsy, superior semicircular canal dehiscence and primary cholesteatoma.


OBJECTIVE
To describe and evaluate the new ZR approach technique in the treatment of traumatic intratemporal facial nerve injuries.


METHODS
This is a prospective clinical study of three consecutive procedures performed between July 2007 and January 2008, and a detailed discription of the surgical technique. The setting is a tertiary referral center. The patients' age range was 3-7 years. Interventions were based on drilling the ZR area extensively, so that the perigeniculate area was exposed through the space created between the middle cranial fossa basal dura and skeletonized external auditory canal. The ZR approach can be performed as an isolated technique or can be combined with an inferior mastoidectomy protecting the bony bridge between.


RESULTS
Two patients had a mixed-type fracture and one patient had a transverse fracture. All three patients received a ZR combined approach. There was no cerebrospinal fluid leak, hearing loss, tympanic membrane perforation or meatal stenosis.
Department of Otorhinolaryngology and Head and Neck Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. ulugt@ttmail.com
Tuncay
T
Ulug
D002648:Child; D002675:Child, Preschool; D035301:Cranial Fossa, Middle / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D005154:Facial Nerve / Q000000981:diagnostic imaging / Q000601:surgery; D020220:Facial Nerve Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005158:Facial Paralysis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005830:Geniculate Ganglion / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000601:surgery; D008866:Microsurgery / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed; D015050:Zygoma / Q000000981:diagnostic imaging / Q000601:surgery*