Auditory Ossicular Malformation and Abnormal Facial Nerve Pathway

Abstract

With progress in imaging diagnosis, conductive hearing loss due to auditory ossicular malformations can now be diagnosed relatively easily, and a satisfactory surgical outcome can often be obtained. However, it is difficult to definitively establish a preoperative diagnosis of abnormal facial nerve pathway in patients with ossicular malformations, and these other conditions are often discovered during surgery. In particular, it is important to detect an abnormal facial nerve pathway preoperatively because surgeons often have to stop reconstruction during the treatment of ossicular malformations due to the risk of nerve damage.
We encountered a patient with malformations of the auditory ossicles (a defect of the long crus of the incus and deformity of stapes) associated with an abnormal facial nerve pathway (uncovered facial nerve sagging against the stapes). Since ossicular malformation and abnormal facial nerve pathway may be embryologically related to each other, it seems important to consider these possibilities when treating patients with malformations of the auditory ossicles.