Transmastoid decompression of the facial nerve in temporal bone fracture.

Among 41 cases of facial palsy caused by closed heart injury, temporal bone fractures were surgically confirmed in 36 cases, of which there were two mixed fractures and 34 longitudinal fractures. The fracture involved the geniculate ganglion area in 20 cases (55%). In 15 cases, decompression of the facial nerve was carried out using the transmastoid supralabyrinthine approach with disarticulation of the incus; in only five cases was the middle fossa approach used. The technique avoids the craniotomy for the middle fossa approach and is a reliable method of treatment in the majority of patients with facial palsy caused by temporal bone fracture involving the geniculate ganglion area.