Objective The aim of this systematic review was to analyse the complex anatomy of the extratemporal portion of the facial nerve with an accurate description of the branching patterns based on the Davis classification. Method Medline, ScienceDirect and the Cochrane Library databases as well as other sources were searched by two independent reviewers. Results Analysis of 21 studies with a total of 1497 cases showed that type III is the most common branching pattern accounting for 26.8 per cent of cases. The type I pattern, previously considered as the normal anatomy in most textbooks, was the fourth most common branching pattern at 16.3 per cent. The majority of specimens (96.4 per cent) were found to have a bifurcated main trunk, and only 3.2 per cent were found with a trifurcated main trunk. Conclusion Surgeons should be aware of anatomical variations in the course of the facial nerve. An early identification of the branching pattern during surgery reduces the risk for iatrogenic facial nerve injury.

Cochlear implants can achieve hearing rehabilitation in individuals with severe and profound sensorineural hearing loss (SNHL) who have little benefit from hearing aids. 1 The conventional microscopic technique was first described in 1976 by House. 2 This traditional approach requires a transmastoid posterior tympanotomy (PT) under a microscopic view. Electrode insertion is achieved either through the round window (RW) or through a bony cochleostomy. 3 Although the success of this approach is undeniable, alternative surgical approaches have been proposed to avoid mastoidectomy complications and minimise the invasive nature of the surgery. [4][5][6] Additionally, PT does not always guarantee satisfactory exposure of the round window niche (RWN) through the facial recess (FR) due

The larynx is an uncommon location for live foreign bodies. The leech can reach the glottis during consumption of contaminated water but is usually expelled by an effective cough reflex. Patients present with hoarseness and dysphagia and occasionally with dyspnea or hemoptysis. Endoscopically, a mobile mass is usually noted in the supraglottic area. We present a rare case of a laryngeal leech in a 62-year-old-male farmer who lives in a rural area. The leech was removed successfully with direct laryngoscopy under general anesthesia.