Facial nerve decompression via middle fossa approach for hyperostosis cranialis interna: a feasible therapeutic approach.
Hyperostosis cranialis interna is an autosomal dominant disorder characterised by endosteal hyperostosis and osteosclerosis of the skull base and calvaria, leading to compression and dysfunction of cranial nerves I, II, VII and VIII.


METHODS
We report the use of bilateral surgical decompression of the internal auditory canals to treat hyperostosis cranialis interna in an eight-year-old girl presenting with bilateral facial palsy due to hyperostosis cranialis interna.


RESULTS
Using a middle fossa craniotomy approach, both internal auditory canals were unroofed and cranial nerves VII and VIII were decompressed, with a one-year interval between sides. The mimic function recovered. One year post-operatively, the right and left facial sides had been restored to House-Brackmann grades I and II, respectively.


CONCLUSIONS
This is the first report of the use of surgical decompression of the internal auditory canal in a case of hyperostosis cranialis interna. Surgical decompression of the internal auditory canal is recommended therapeutically, but may also be performed prophylactically in younger patients with hyperostosis cranialis interna.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Maastricht, The Netherlands. J.Waterval@gmail.com
J J
JJ
Waterval
R J
RJ
Stokroos
R B J
RB
De Bondt
J J
JJ
Manni
D002648:Child; D035301:Cranial Fossa, Middle / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods* / Q000592:standards; D007758:Ear, Inner / Q000601:surgery; D005154:Facial Nerve; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015576:Hyperostosis / Q000235:genetics / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards; D013506:Otologic Surgical Procedures / Q000379:methods / Q000592:standards; D010375:Pedigree; D016896:Treatment Outcome; D000159:Vestibulocochlear Nerve / Q000601:surgery