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Background <p>Iatrogenic facial nerve dysfunction following ear surgery can be devastating for patients. These individuals anticipate improved hearing post-surgery but may experience socially challenging asymmetric facial movements instead. Given the proximity of the facial nerve (FN) to pathologies within the tympanic cavity, FN paralysis remains one of the most serious complications associated with otological procedures. Therefore, a thorough understanding of the surgical anatomy of the FN, including its pediatric variations, is crucial for preventing iatrogenic FN injuries.</p> Objective <p>In this study, we present the morphometric changes of the FN as children grow from birth to 18 years old, and explore its relationship with key structural landmarks on the skull.</p> Methods <p>Computed tomography (CT) images of the temporal bone of children aged 0–18 years digitally stored between 2008 till 2022 were retrospectively retrieved. Samples were divided into age-specific motor development groups. Both sides of one candidate were assessed separately. The length and width of the FN and its distances to marking points on the skull were assessed with dedicated image handling software (Radiant Dicom Viewer). The length and width of the FN and its distances to marking points on the skull were assessed with dedicated image handling software. SPSS 22.0 was used for statistical analysis, and p &lt; 0.05 was accepted as statistically significant.</p> Results <p>CT images of 69 children (138 sides, mean age:10.06 ± 5.24), 34 boys and 35 girls were examined. The mean FN length(FN-L) and width(FN-W) were 11.09 ± 2.07mm and 1.59 ± 0.30mm, respectively. Mean distances of FN measured to mastoid surface(FN-M) 12.79 ± 2.98 mm, to external auditory canal(FN-EAC) 3.73 ± 1.49mm, to sigmoid sinus(FN-SS) 10.98 ± 2.52mm, to posterior cranial fossa(FN-PCF) 6.06 ± 2.25mm, and to midline of cranium(FN-MC) were 40 ± 4.22mm. FN-L, FN-M, FN-EAC and FN-MC have been changed between the age groups. For the parameters showing significant changes over the years the regression equations for age were calculated as y = 1.481 + (0.012*age) for FN-W, y = 8.335 + (0.288*age) for FN-L, y = 10.267 + (0.263*age) for FN-M, y = 4.274 + (-0.056*age) for FN-EAC.</p> Conclusion <p>Our findings demonstrate that the anatomical location and dimensions of the facial nerve in the temporal bone change during childhood. As determined in this study, FN is quite superficial in early childhood, which may make it more vulnerable. The regression equations may aid in preoperative surgical planning and prevention of iatrogenic injuries of FN in cases that have no preoperative imaging available.</p>

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Morphometric Evaluation of the Mastoid Segment of the Facial Nerve in Children

  • 期刊论文

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  • 发表日期：

    2025年7月3日

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  • Saliha Seda Adanır,
  • Piraye Kervancıoğlu,
  • İlhan Bahşi,
  • Mohammad Al Saadi,
  • Vedat Topsakal

摘要

Background

Iatrogenic facial nerve dysfunction following ear surgery can be devastating for patients. These individuals anticipate improved hearing post-surgery but may experience socially challenging asymmetric facial movements instead. Given the proximity of the facial nerve (FN) to pathologies within the tympanic cavity, FN paralysis remains one of the most serious complications associated with otological procedures. Therefore, a thorough understanding of the surgical anatomy of the FN, including its pediatric variations, is crucial for preventing iatrogenic FN injuries.

Objective

In this study, we present the morphometric changes of the FN as children grow from birth to 18 years old, and explore its relationship with key structural landmarks on the skull.

Methods

Computed tomography (CT) images of the temporal bone of children aged 0–18 years digitally stored between 2008 till 2022 were retrospectively retrieved. Samples were divided into age-specific motor development groups. Both sides of one candidate were assessed separately. The length and width of the FN and its distances to marking points on the skull were assessed with dedicated image handling software (Radiant Dicom Viewer). The length and width of the FN and its distances to marking points on the skull were assessed with dedicated image handling software. SPSS 22.0 was used for statistical analysis, and p < 0.05 was accepted as statistically significant.

Results

CT images of 69 children (138 sides, mean age:10.06 ± 5.24), 34 boys and 35 girls were examined. The mean FN length(FN-L) and width(FN-W) were 11.09 ± 2.07mm and 1.59 ± 0.30mm, respectively. Mean distances of FN measured to mastoid surface(FN-M) 12.79 ± 2.98 mm, to external auditory canal(FN-EAC) 3.73 ± 1.49mm, to sigmoid sinus(FN-SS) 10.98 ± 2.52mm, to posterior cranial fossa(FN-PCF) 6.06 ± 2.25mm, and to midline of cranium(FN-MC) were 40 ± 4.22mm. FN-L, FN-M, FN-EAC and FN-MC have been changed between the age groups. For the parameters showing significant changes over the years the regression equations for age were calculated as y = 1.481 + (0.012*age) for FN-W, y = 8.335 + (0.288*age) for FN-L, y = 10.267 + (0.263*age) for FN-M, y = 4.274 + (-0.056*age) for FN-EAC.

Conclusion

Our findings demonstrate that the anatomical location and dimensions of the facial nerve in the temporal bone change during childhood. As determined in this study, FN is quite superficial in early childhood, which may make it more vulnerable. The regression equations may aid in preoperative surgical planning and prevention of iatrogenic injuries of FN in cases that have no preoperative imaging available.