[Decompression and monitor of facial nerve during cholesteatoma surgery in petrous part of temporal bone].

OBJECTIVE: To study the application of facial nerve monitoring and to estimate the therapeutic effectiveness of the total decompression of facial nerve during the surgery for cholesteatoma in petrous bone by middle cranial fossa-mastoid process approach. METHOD: Eight cases who suffered from chronic suppurative otitis media (cholesteatoma type) in petrous bone were treated with open technique, three other cholesteatoma cases whose tympanic membranes were intact was treated with close technique. Monitoring for facial nerve integrity during operation was applied. Total decompression of facial nerve was performed in all patients. House-Brackmann grading system was used to evaluated the recovery of facial nerve function. RESULT: Facial paralysis recovered gradually during the period of 3 to 6 months after operation. After 6 to 12 months follow-up in 11 cases, 1 case regained basically normal status, 9 cases recovered to mild facial paralysis and 1 case still needed further follow-up. There was no recurrence of cholesteatoma in all patients. CONCLUSION: Middle cranial fossa-mastoid process combining approach technique is effective for cholesteatoma in petrous bone and total decompression of facial nerve at the same stage. Nerve monitor is helpful in orientating facial nerve during operation and in preventing possible damage to the facial nerve.