ISSN 1308-7649 | E-ISSN 2148-3817
Case Report
Deceptive Facial Nerve Variant May Cloud Otologists’ Judgment: A Dilemma in Middle Ear Surgery
1 Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China  
2 Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China  
3 Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China  
J Int Adv Otol 2014; 10: 291-293
DOI: 10.5152/iao.2014.333
Key Words: Cholesteatoma, facial nerve, mastoid, middle ear surgery, temporal bone
Abstract

Tympanomastoid surgery constitutes the vast majority of procedures performed by otologists. Intra-operatively, identifying the facial nerve is always a challenge. We present an unusual case of fibrous connective tissue mimicking a facial nerve variant during cholesteatoma surgery. The variant was inadvertently damaged during surgery, and we feared devastating complications; however, the pathology revealed that it was not the actual facial nerve. This case is important, in that it serves as a reminder for otologists to be aware of the many possible presentations of the facial nerve in otologic surgery.

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