Surgical Dimensions of the Facial Recess in Adults and Children

Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX 77030.
Archives of Otolaryngology - Head and Neck Surgery (Impact Factor: 2.33). 06/1988; 114(5):534-7. DOI: 10.1001/archotol.1988.01860170064020
Source: PubMed


The facial recess approach permits surgical access to the round window area. This route is used in patients who are undergoing cochlear implantation. To evaluate the feasibility of this procedure in children as compared with adults, serial sections of temporal bones were used to measure the surgical dimensions of the facial recess. No statistically significant differences in the dimensions of the facial recess or the extended facial recess approaches were found between children and adults. The relationship of the facial and chorda tympani nerves to the annular plane exhibited no change with postnatal growth. These structures translate posteriorly and laterally toward the annular plane as they descend within the temporal bone. Therefore, the facial recess approach represents no greater hazard in a child than in an adult.

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    ABSTRACT: The anatomic variations of the facial recess are of interest in certain otosurgical procedures. The medial border of the recess is the mastoid portion of the facial nerve canal, and the lateral border is the bony canal of the chorda tympani. These two structures were investigated in 64 polyester casts of temporal bone specimens. The point of exit of the chorda tympani canal from the facial canal was assessed together with the angle, formed between these two nerve channels. As a further way of describing the spaciousness at the facial recess, the distance between the sulcus of the stapedius muscle and the chorda tympani canal was evaluated.
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    ABSTRACT: More attention is being focused on the growth and development of the facial recess because of the use of cochlear implantation in children over 2 years of age and the prospect of using implants in even younger children. The facial recess and the extended facial recess were measured in 123 temporal bones from 73 individuals ranging in age from 8 weeks in utero to 7 years after birth. The goals were to trace the development of the facial recess and to determine whether this area continues to grow into childhood.The facial recess enlarges throughout fetal life with the development of the facial canal and the tympanic annulus. Reichert's cartilage, seen early in utero in the facial recess, gradually resorbs but may persist in the newborn. In full-term infants, the facial recess reaches 3.25 mm at the oval window and 2.62 mm at the round window. The extended facial recess reaches 3.79 mm at the oval window and 3.04 mm at the round window. No statistically significant growth of the facial recess after birth could be demonstrated in this study. The data suggest that the facial recess is probably adult sized at birth and should allow surgical access for cochlear implantation in very young children.Laryngoscope, 106 (Suppl. 80):1-7, 1996
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