title: Anomalous facial nerve in congenital stapes fixation.
abstract: OBJECTIVE
  The aim of this article was to assess the prevalence and influence of anomalous facial nerves in patients undergoing surgery for congenital stapes anomalies.
  
  
  METHODS
  The medical records of all patients who underwent surgery for congenital stapes fixation between January 1999 and December 2012 were retrospectively reviewed. An abnormal facial nerve was found in 7 ears in 5 patients (from a total of 62 ears).
  
  
  METHODS
  The patients' temporal bone computed tomography results, operation records, video clips, and preoperative and postoperative hearing tests were reviewed.
  
  
  RESULTS
  Oval window atresia was found in all 7 ears, and the facial nerves in all 7 ears ran inferior medially over the atretic oval window niche. The atretic plate was fenestrated into the vestibule in the superior margin of the facial nerve. A piston wire was anchored to the long process of the incus in 3 ears, to the handle of the malleus in 3 ears, and attached to the tympanic membrane in 1 ear. The postoperative ABG at long-term follow-up was 13.1 dB (SD, 4.6 dB; range, 8.8-18.3 dB). No patient had postoperative facial weakness.
  
  
  CONCLUSIONS
  An anomalous facial nerve was found in 11.2% of ears in patients undergoing surgery for congenital stapes fixation. Despite the anomalous course of facial nerves in these patients, vestibular fenestration was successful without facial nerve damage. The audiometric outcome at long-term follow-up was serviceable hearing for all cases.
authors.affiliation: *Department of Otolaryngology, and †Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Yun Suk
authors.initials: YS
authors.lastname: An
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Kwang-Sun
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D001299:Audiometry; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004429:Ear Ossicles / Q000002:abnormalities / Q000601:surgery; D005154:Facial Nerve / Q000002:abnormalities*; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008307:Malleus / Q000601:surgery; D010046:Oval Window, Ear / Q000033:anatomy & histology; D011859:Radiography; D012189:Retrospective Studies; D013199:Stapes / Q000002:abnormalities*; D013200:Stapes Mobilization / Q000379:methods*; D013201:Stapes Surgery / Q000379:methods*; D013701:Temporal Bone / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000033:anatomy & histology