Facial nerve monitoring in surgery for congenital auricular atresia.

Surgery for congenital auricular atresia places the facial nerve at risk because of its potential aberrancy; iatrogenic facial paralysis is a well-known potential risk. Five cases of congenital auricular atresia are presented. All patients had intraoperative monitoring of the facial nerve. The facial nerve was found to be abnormally displaced, usually due to hypoplasia of the tympanic ring. Preoperative and postoperative facial nerve function was unchanged by surgery. Facial nerve monitoring is an important adjunct in congenital ear surgery because it allows for early and precise identification of the nerve in the absence of normal surgical landmarks and provides for continuous monitoring of the nerve.