The geniculate ganglion is the sensory ganglion of the facial nerve, sitting at its first sharp bend (the genu) inside the facial canal of the petrous temporal bone. It holds the cell bodies of the taste fibres from the front two-thirds of the tongue and from the palate, plus a few fibres of general sensation from the ear. The greater petrosal nerve leaves the facial nerve here.
| Origin | Cell bodies of the sensory fibres of the facial nerve (nervus intermedius component) |
|---|---|
| Course | Lies at the genu of the facial nerve in the facial canal, where the nerve turns sharply backward; the greater petrosal nerve leaves it anteriorly toward the middle cranial fossa |
| Motor |
|
| Sensory |
|
Reactivation of varicella zoster virus in the geniculate ganglion causes Ramsay Hunt syndrome (herpes zoster oticus), with severe ear pain, vesicles in the ear canal or on the auricle, and facial palsy that often recovers less completely than Bell palsy. The ganglion is a key landmark for localising facial nerve lesions: damage at or above it also reduces tear production, because the greater petrosal nerve is involved. Temporal bone fractures frequently injure the nerve at the ganglion.
Herpes zoster reactivation in the geniculate ganglion produces ear pain, a vesicular rash of the ear and an acute facial palsy, sometimes with hearing loss and vertigo. Early antiviral treatment combined with corticosteroids improves the chance of recovery.
Fractures through the petrous temporal bone often damage the facial nerve near the geniculate ganglion, causing immediate or delayed facial palsy. Immediate complete palsy may need surgical decompression.
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