A case of an osseous lesion around the stapes following facial nerve decompression

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  • Nouchi Mai
    Department of Otolaryngology, Head and Neck Surgery, Tokyo Metropolitan Tama Medical Center Department of Otorhinolaryngology, Mitsui Memorial Hospital
  • Kinoshita Makoto
    Department of Otorhinolaryngology, Mitsui Memorial Hospital Department of Otolaryngology, Faculty of Medicine, the University of Tokyo
  • Inoue Yuta
    Department of Otorhinolaryngology, Mitsui Memorial Hospital Inoue ENT Clinic
  • Nishimura Shinichi
    Department of Otorhinolaryngology, Mitsui Memorial Hospital
  • Okuno Taeko
    Department of Otorhinolaryngology, Mitsui Memorial Hospital

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Other Title
  • アブミ骨周囲に硬化病変を生じた顔面神経減荷術後症例
  • アブミ ホネ シュウイ ニ コウカ ビョウヘン オ ショウジタ ガンメン シンケイ ゲン カ ジュツゴ ショウレイ

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Abstract

<p>We report a case of postoperative conductive hearing loss due to an osseous lesion around the stapes following facial nerve decompression. A 46-year-old, male patient with severe peripheral facial nerve palsy underwent transmastoid decompression of the facial nerve. Postoperatively, an audiogram showed conductive hearing loss of approximately 30 dB. Six months later, the patient underwent an exploratory tympanotomy, which demonstrated limited improvement in his hearing. He visited Mitsui Memorial Hospital for consultation 13 months postoperatively and underwent a reoperation.</p><p>There was no lesion around the incus although it was dislocated and had been repositioned at the first operation; however, an osseous lesion around the stapes to the promontory was found.</p><p>The stapes could move smoothly after laser ablation of the osseous fixation, and his hearing level improved to approximately 16 dB. In this case, the osseous lesion around the stapes was considered to have formed with bone dust remaining in the tympanic cavity during the facial nerve decompression operation combined with the fibrin glue used at the time of ossicular chain reconstruction. In conclusion, we should take care to wash out bone residue sufficiently in facial nerve decompression.</p>

Journal

  • Otology Japan

    Otology Japan 32 (2), 222-226, 2022

    Japan Otological Society

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