Oren N, et al. - Researchers conducted this retrospective analysis to categorize anomalous tympanic facial nerve (FN) on high-resolution computed tomography (HRCT) and to determine the importance of related temporal bone anomalies and non-microtia congenital syndromes in patients with hearing loss. The study sample consisted of HRCT findings in 30 temporal bones in 18 patients with anomalous FN. According to findings, HRCT shows that even without oval window atresia [defined as the lack of the structure with the presence of a bony plate superimposed between the vestibule and middle ear], anomalous tympanic FNs are correlated with CHL. In addition, in the absence of external auditory canal atresia, an anomalous tympanic FN in conjunction with inner ear anomalies appears to be a biomarker for certain congenital temporal bone syndromes with hearing loss. Therefore, in assessing hearing loss especially before surgery, HRCT of the temporal bone should be regarded to prevent potential iatrogenic FN injury and to diagnose inner and middle ear defects in the presence of normal external auditory canal or pinna.