title: Stapes fixation accompanied with abnormal facial nerve pathway.
abstract: The patient was a 52-year-old woman. She had been aware of her bilateral hearing loss since she was 20 years old. The hearing in her left ear started to deteriorate at the age of 49. Pure-tone audiometry showed a bilateral mixed hearing loss. The hearing levels for the right ear and the left ear were 52 dB and 68 dB, respectively. There were no remarkable findings in a computed tomography (CT) scan of the temporal bone. We suspected that she had otosclerosis, and an operation was performed on her left ear. When the incudostapedial joint (I-S joint) was exposed to investigate the movement of the stapes, a soft white band that ran under the superstructure of the stapes was noted. By using a nerve monitoring system, we confirmed that the white band was the bare facial nerve. The ossicular chain was normal, except for a malformed stape due to the facial nerve, and the footplate of the stapes was fixed. Therefore, she was diagnosed as having otosclerosis with an abnormal facial nerve pathway. The malformed superstructure of the stapes was removed carefully. When the ectopic facial nerve was shifted to anteroinferior side, the oval window could be seen. Stapedotomy using a Teflon piston prosthesis was performed with no complications.
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: inataro@tokyo-med.ac.jp.
authors.forename: Taro
authors.initials: T
authors.lastname: Inagaki
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawano
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Negishi
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kawada
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D001301:Audiometry, Pure-Tone; D005154:Facial Nerve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010040:Otosclerosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013201:Stapes Surgery / Q000379:methods*; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Abnormal facial nerve pathway; Otosclerosis; Stapes surgery