简介：Objectives:Facialnerveaberrationisthemosttroublesomesituationincongenitalmalformationsofmiddleear.Theaimofourstudyistoinvestigateitsimagingandclinicalfeaturesaswellasrelevantchoiceofsurgicaltechniquesforhearingimprovement.Methods:Aretrospectivestudyinvolvingreviewofclinicaldataof227patients(256ears)withcongenitalmiddleearanomalywasundertaken,includingpreoperativecomputedtomography(CT)data,surgicalrecordsandvideos.Results:Aberrationinvolvingintratemporalfacialnervewasfoundin82/256ears(32.03%)withcongenitalmiddleearanomaly.Themostcommonformsofaberrationincludedoverhangingovertheovalwindow(50/82ears,60.98%),bifurcation(3/82ears,3.66%)andtransverseoverthepromontory(3/82ears,3.66%),countingfor68.29%(56/82)ofthecaseswithfacialnerveaberration.Concomitantstapesmalformationwasfoundin76/82ears(92.68%)andatresiaorstenosisoftheovalwindowin27/82ears(32.93%).In9/82ears(10.98%)bothstapesandovalwindowwasabsent.Electivesurgeriesforthepurposeofhearingimprovementincludedstapodotomy+pistonimplantation,labyrinthotomy,labyrinthotomy+totalossicularreplacementprosthesis(TORP)implantationandVibrantSoundbridge(VSB)implantation.Conclusion:Themajorityoffacialnerveaberrationincongenitalmalformationofmiddleearinvolvesdisplacementoffacialnerve,inadditiontoconcomitantmalformationsofthestapesand/orovalwindow,whichmayinfluencethechoiceofsurgeryforhearingimprovement.VSBimplantationmaybeconsideredasausefuloption.