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Background <p>The facial canal (FC) houses the facial nerve within the temporal bone, and its dehiscence (FCD) can increase the risk of nerve injury during otologic procedures or as a complication of middle ear diseases. Despite its clinical significance, the prevalence and risk factors for FCD remain poorly defined, including microdehiscence (mFCD) and macrodehiscence (MFCD).</p> Objectives <p>This systematic review and meta-analysis aimed to determine the combined prevalence of FCD, categorize its anatomical and pathological distribution, and assess its correlation with otologic disorders.</p> Methods <p>A systematic search of multiple databases was conducted following PRISMA guidelines. Observational studies reporting FCD prevalence in healthy individuals and patients with otologic conditions were included. Random-effects meta-analyses were performed to compute pooled prevalence and odds ratios (OR), with heterogeneity assessed using I² and Cochrane’s Q.</p> Results <p>A total of 62 studies were analyzed. The pooled prevalence of FCD was 18% [95% CI, 0.15–0.23]. mFCD was more frequent in postmortem (54%) and CT studies (35%), while MFCD was observed in 21% of postmortem cases and 16% of pathological conditions. Cholesteatoma significantly increased MFCD risk (OR = 6.14, 95% CI, 4.39–8.57). MFCD was more prevalent in adults (OR = 1.95, 95% CI, 1.21–3.14) and revision surgeries (OR = 1.64, 95% CI, 1.20–2.24).</p> Conclusions <p>FCD is a common anatomical variation, particularly in otologic pathologies. Preoperative assessment is crucial to prevent facial nerve injury. Further research on its embryological and clinical implications is warranted.</p>

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The patho-anatomy of facial or fallopian canal dehiscence: a systematic review with meta-analysis of observational studies

  • 期刊论文

  • 发表日期：

    2025年6月23日

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  • Adil Asghar,
  • Ravi Kant Narayan,
  • Ananya Priya,
  • Kranti Bhavana,
  • Bhartendu Bharti,
  • Pradosh Kumar Sarangi

摘要

Background

The facial canal (FC) houses the facial nerve within the temporal bone, and its dehiscence (FCD) can increase the risk of nerve injury during otologic procedures or as a complication of middle ear diseases. Despite its clinical significance, the prevalence and risk factors for FCD remain poorly defined, including microdehiscence (mFCD) and macrodehiscence (MFCD).

Objectives

This systematic review and meta-analysis aimed to determine the combined prevalence of FCD, categorize its anatomical and pathological distribution, and assess its correlation with otologic disorders.

Methods

A systematic search of multiple databases was conducted following PRISMA guidelines. Observational studies reporting FCD prevalence in healthy individuals and patients with otologic conditions were included. Random-effects meta-analyses were performed to compute pooled prevalence and odds ratios (OR), with heterogeneity assessed using I² and Cochrane’s Q.

Results

A total of 62 studies were analyzed. The pooled prevalence of FCD was 18% [95% CI, 0.15–0.23]. mFCD was more frequent in postmortem (54%) and CT studies (35%), while MFCD was observed in 21% of postmortem cases and 16% of pathological conditions. Cholesteatoma significantly increased MFCD risk (OR = 6.14, 95% CI, 4.39–8.57). MFCD was more prevalent in adults (OR = 1.95, 95% CI, 1.21–3.14) and revision surgeries (OR = 1.64, 95% CI, 1.20–2.24).

Conclusions

FCD is a common anatomical variation, particularly in otologic pathologies. Preoperative assessment is crucial to prevent facial nerve injury. Further research on its embryological and clinical implications is warranted.