Operative Exposure of the Facial Canal: With Removal of a Tumor of the Greater Superficial Petrosal Nerve

A case of operative exposure of the facial canal with removal of a tumor of the greater superficial petrosal nerve is reported in order to describe the procedure and because no other description of a perineurial fibroblastoma arising in the vicinity of the geniculate ganglion is to be found in the literature. The presenting symptom was facial paralysis. But preliminary tests localized the site of interruption to the genu of the facial nerve, and exploration was undertaken with a view to a possible end-to-end suture within the petrous bone. In 1908 Alt1suggested a means of opening the facial canal, and in 1922 Ney2reported a method of decompression of the nerve and suture worked out on the cadaver. The more recent work of Ballance and Duel3on nerve grafts in the treatment of facial palsy contains also a complete bibliography of the subject.