• Nicholas Jufas and Manohar Bance.
• Division of Otolaryngology - Head and Neck Surgery, Dalhousie University, 3rd Floor Dickson Building, VG Site, QE II Health Sciences Centre, 5820 University Ave, Halifax, NS, B3H 2Y9, Canada. drnicholasjufas@gmail.com.
• J Otolaryngol Head N. 2017 Aug 22; 46 (1): 53.

BackgroundEndoscopic transcanal approaches to the facial nerve allow excellent exposure of the tympanic facial nerve. This approach becomes limited when access is required to the more proximal geniculate ganglion and labyrinthine portion of the facial nerve. The aim of this report was to determine the feasibility of a transmastoid endoscopically assisted approach to the geniculate ganglion and labyrinthine facial nerve. This is an endoscopic cadaveric dissection and video review at a university anatomical laboratory.MethodsA total of 12 endoscopic cadaveric dissections were performed. A cortical mastoidectomy and perilabyrinthine air cell removal was performed using an operating microscope. Beyond this, dissection was performed with an endoscope.ResultsIn all dissections, an endoscopically assisted transmastoid approach allowed complete access to the geniculate ganglion, and at least 1.5 mm of the distal labyrinthine facial nerve. Further transcrusal drilling through the anterior crus of the superior semicircular canal allowed access to the entire labyrinthine facial nerve.ConclusionsThe entire geniculate ganglion and labyrinthine facial nerve is difficult to access with microscopic techniques. Adding endoscopic visualization allows for complete visualization of the geniculate ganglion. Clinical reports will further strengthen these preliminary cadaveric results.

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