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KMID : 0390220000110010120
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2000 Volume.11 No. 1 p.120 ~ p.123
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A Case of Bifurcation of the Facial Nerve in Mastoid Segment
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황동조/Dong Jo Hwang
김정수/문준환/이승은/Jeong Soo Kim/Jun Hwan Moon/Seung Eun Lee
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Abstract
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Recently, we have experienced a case of bifurcation of the facial nerve in mastoid segment during the middle ear
surgery by accident. The patient was a 51 year-old female who had the symptoms of hearing impairment and
intermittent otorrhea in left ear for 10 year. Temporal bone computed tomograph showed suspicious findings
of bifurcated facial nerve in mastoid segment. In operative findings, outer branch of the bifurcated facial nerve
proceded 5mm from distal part of the 2nd genu and then rejoined with posteromedial curved branch of that at
above the stylomastoid foramen. According to the reports, variations in the anatomic course of the facial nerve
in mastoid segment are very rare. The type of anatomic variation in mastoid segment can be subdivided into
three categories by Procter and Nager as followings. The 1st type is slightly anteriorly, posteriorly curve when
viewed laterally, medially or laterally curved when viewed behind. The 2nd type is a bifurcation of trifurcation
on posterior part of oval window or distal end and the 3rd type is hypoplasia of facial nerve. In order to aviod
injury to the facial nerve, operator should check up the temporal bone CT findings thoroughly and keep
variations of the facial nerve in mind during the middle ear surgery.
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