Facial Nerve Decompression

What is Facial Nerve Decompression?

Facial nerve decompression is a surgical procedure in which the abnormal compression on the facial nerve is relieved. It is performed to improve blood circulation and minimize damage to the nerve fibers.

The facial nerve is the seventh cranial nerve and it follows an intracranial path through the cranium and an extracranial path through the face and neck with a combination of sensory, motor and parasympathetic fibers. Since it is also the longest nerve to travel inside a bony canal and follows a complex course the facial nerve is highly susceptible to injury.

Paralysis or weakness of the facial nerve may occur due to herpes zoster oticus infection, inflammation, trauma, tumors and tympanotomy. Compression on the facial nerve results in facial muscle weakness, facial paralysis, Bell's palsy and facial drooping which alters facial expressions and is also a cosmetic deformity.

What are the Types of Facial Nerve Decompression?

The different types of facial nerve decompression depend on the location of facial nerve injury and whether there is an associated hearing loss or not.

• Transmastoid approach: This approach is useful if the mastoid or tympanic segments of the Facial nerve are affected.
• Middle fossa approach: Middle fossa or temporal fossa facial nerve decompression is the method of choice when the Facial nerve is affected due to temporal bone trauma but hearing is intact.
• Translabyrinthine approach: The translabyrinthine approach is useful in cases where there is a complete loss of hearing.

Who Should Undergo this

Surgery?

• Cases where other lesser invasive treatments or medications have failed
• Patients in whom the facial nerve is intact
• Cases where there is severe inflammation, edema and compression of the facial nerve and there is progressive vertigo or deafness
• Those who are at risk of permanent paralysis
• Cases which have a poor prognosis without surgical intervention
• Patients with facial paralysis due to herpes zoster oticus, trauma, infections, Bell's palsy or surgical procedures such as tympanotomy
• Patients who view facial drooping as a cosmetic deformity and desire operative intervention