[Microsurgical anatomy of intracranial segment of facial nerve].

OBJECTIVE: To study the microsurgical anatomy of intracranial segment of facial nerve so as to provide anatomic parameters for clinical operation. METHODS: Ten adult cadavers were fixed and perfused with color silicon. Facial nerves of these cadavers were observed and measured under operative microscope according to lateral cranial base operative approach. Ten dry skulls were dissected to observe the relationships of osseous structures. The anatomic relationship and data of different segment of facial nerve were obtained respectively. RESULTS: The facial nerve was divided into five segments, namely, cerebellopontine angle segment, internal acoustic meatus segment, labyrinthine segment, tympanum segment and mastoid segment. The cerebellopontine angle segment and internal acoustic meatus segment paralleled the vestibulocochlear nerve. The labyrinthine aegment is the finest and shortest with the lebgth of 3.8 mm +/- 0.7 mm. The tympanum segment is closely related with osseous labyrinth. The mastoid segment, 15.5 mm +/- 1.9 mm long, leaves the cranium from stylomastoid foramen. CONCLUSION: Facial nerve can be located with choroid plexus of the fourth ventricle in retrosigmoid approach. Arcuate eminence and greater superficial petrosal nerve are important mark to locate internal acoustic meatus segment and labyrinthine segment in antepetrosal approach. Tympanum segment may be exposed on the surface of petrous bone in some cases. The line between lateral semicircular canals and crista of digastric muscle is the mark of mastoid segment.