An anomalous facial nerve: The otologist's albatross

A facial nerve coursing inferior to the oval window niche was injured during a stapedectomy. In this location, the nerve did not have normal gross characteristics and was not recognized as a vital structure. The relationship between the facial nerve and the stapes is determined by the fourth week of fetal life. Even when the nerve lies inferior to the stapes, it is postulated that a normal bony facial canal and stapedial muscle can develop.