Trans-tensor tympani facial nerve decompression in traumatic facial nerve palsy.

OBJECTIVE: The surgical approaches previously reported for facial nerve decompression have focussed on achieving good exposure of the lateral or superior aspects of the geniculate ganglion. This report aims to describe a unique case of facial nerve decompression beneath the geniculate ganglion. PATIENT: A 30-year-old woman with right-sided facial palsy due to a temporal bone fracture. INTERVENTION: Bony fragments at the base of the geniculate ganglion were removed via a trans-tensor tympani approach with extended posterior tympanotomy. RESULTS: The patient's facial movement recovered successfully, without complications such as sensorineural hearing loss and conductive hearing loss. CONCLUSION: In rare cases requiring decompression of the facial nerve inferior to the perigeniculate area, the trans-tensor tympani approach should be considered as a valuable alternative option when surgical intervention is considered.

Reduction osteoplasty for treating pneumosinus dilatans of the maxillary sinus.

OBJECTIVE: To report a patient with maxillary pneumosinus dilatans and facial deformity treated by reduction osteoplasty and reconstruction. CASE REPORT: This study describes the successful management of facial deformity in a 17-year-old male with maxillary pneumosinus dilatans. The patient's facial deformity of the maxillary sinus, which had been slowly progressing over a 10-year period, was managed by reduction osteoplasty and reconstruction using the maxillary bone, conchal cartilage and Tutoplast-processed fascia lata via a sublabial approach. This treatment yielded satisfactory functional and aesthetic outcomes. CONCLUSION: As pneumosinus dilatans of the maxillary sinus is uncommon, there is no established surgical treatment protocol. This surgical technique was less invasive than other described procedures and revealed good cosmetic results.