title: Sectional anatomy aid for improvement of decompression surgery approach to vertical segment of facial nerve.
abstract: The aim of this study was to find a surgical approach to a vertical segment of the facial nerve (VFN) with a relatively wide visual field and small lesion by studying the location and structure of VFN with cross-sectional anatomy. High-resolution spiral computed tomographic multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane. To locate the VFN, we measured the distances as follows: from the VFN to the paries posterior bony external acoustic meatus on 5 typical multiplane reformation images, to the promontorium tympani and the root of the tympanic ring on 2 typical images. The mean distances from the VFN to the paries posterior bony external acoustic meatus are as follows: 4.47 mm on images showing the top of the external acoustic meatus, 4.20 mm on images with the best view of the window niche, 3.35 mm on images that show the widest external acoustic meatus, 4.22 mm on images with the inferior margin of the sulcus tympanicus, and 5.49 mm on images that show the bottom of the external acoustic meatus. The VFN is approximately 4.20 mm lateral to the promontorium tympani on images with the best view of the window niche and 4.12 mm lateral to the root of the tympanic ring on images with the inferior margin of the sulcus tympanicus. The other results indicate that the area and depth of the surgical wound from the improved approach would be much smaller than that from the typical approach. The surgical approach to the horizontal segment of the facial nerve through the external acoustic meatus and the tympanic cavity could be improved by grinding off the external acoustic meatus to show the VFN. The VFN can be found by taking the promontorium tympani and tympanic ring as references. This improvement is of high potential to expand the visual field to the facial nerve, remarkably without significant injury to the patients compared with the typical approach through the mastoid process.
authors.affiliation: Department of Radiology, The First Affiliated Hospital, Jilin University, Changchun, Jilin Province, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Feng
authors.forename: Yi Qun
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.forename: Limin
authors.initials: L
authors.lastname: Jin
authors.forename: Mingmei
authors.initials: M
authors.lastname: Huangfu
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Liu
authors.forename: Peiyan
authors.initials: P
authors.lastname: Hua
authors.forename: Yulong
authors.initials: Y
authors.lastname: Liu
authors.forename: Ruida
authors.initials: R
authors.lastname: Hou
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.forename: You Qiong
authors.initials: YQ
authors.lastname: Li
authors.forename: Yu Fa
authors.initials: YF
authors.lastname: Wang
authors.forename: Jia Chun
authors.initials: JC
authors.lastname: Feng
mesh_terms: D000328:Adult; D019412:Anatomy, Cross-Sectional; D019299:Decompression, Surgical; D005154:Facial Nerve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed