About Video

This video demonstrates the technique preferred by the authors using a ‘superior prelabyrinthine cell tracts approach’. The superior semicircular canal is used as a landmark to trace the geniculate ganglion and subsequently the internal auditory canal. Total decompression of the facial nerve is indicated in severe facial nerve palsy of grade 5 or higher, in the House Brackman grading system, or of 10 points or lower in Yanagihara facial nerve grading system. It can also be performed in cases with a sign of nerve degeneration, despite medical treatment with antiviral agents and steroids. Also patients who have electromyographic responses of less than 10 percent of the normal side within two weeks of the onset of facial palsy may benefit from this surgery. In the authors’ experience, the Yasargil-type brain retractor is helpful to elevate the tegmen dura. Alternatively, the middle fossa approach can be taken to perform the same surgery.