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Point of Vulnerability of Facial Nerve during Mastoid Surgery in Indian Patients

Manu Malhotra, Associate Professor, Department of Otolaryngology, AIIMS, Veerbhadra Marg, Rishikesh,Uttarakhand- 240201 , Rashmi Malhotra* , Manu Malhotra**

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Indian Journal of Anatomy 6(2):p 109-113, . | DOI: http://dx.doi.org/10.21088/ija.2320.0022.6217.3
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Abstract

Aims and objectives: This study aims at finding out the area of highest vulnerability for iatrogenic facial nerve injury during mastoid exploration done for chronic suppurative otitis media in Indian patients. Study Design: Multi-centric, retrospective survey. Material and Methods: A questionnaire was sent to 60 different otologists in India, out of which data provided by 20 surgeons with at least 10 years of experience was recorded and analysed statistically after blinding of the surgeon’s names. Results: Out of the 3962 mastoid surgeries analysed mean incidence of nerve dehiscence was 3.1 ± 0.98 %. Mean incidence of iatrogenic nerve injury was 2.4 ± 0.79 %. Majority (57.6%, n=53) of the patients reportedly had maximum House Brackmann clinical grade III facial paralysis at diagnosis. Majority, 85.87% (n=79) were reported to have occurred at second genu, 9.78% (n=9) at vertical portion and 4.34% (n=4) at horizontal portion. Most of injuries (77.17%, n=71) recovered completely. Conclusion: Despite of the interpersonal and interracial variations reported in the literature, and the commonest site of nerve dehiscence being horizontal portion in the intra-tympanic course, the region of the second genu is the most vulnerable point of injury and should be dealt with extra caution.


Keywords: Facial Nerve; Temporal Bone; Otitis Media  

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  • Manu Malhotra, Associate Professor, Department of Otolaryngology, AIIMS, Veerbhadra Marg, Rishikesh,Uttarakhand- 240201
    ,
  • Rashmi Malhotra*
    ,
  • Manu Malhotra**
    ,
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DOI: http://dx.doi.org/10.21088/ija.2320.0022.6217.3
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