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Surgical and Radiologic Anatomy
Published in: Surgical and Radiologic Anatomy 6/2016

01-08-2016 | Original Article

Posterior tympanotomy is a riskier procedure in chronic otitis media than in a normal mastoid: a high-resolution computed tomography study

Authors: Chang Woo Kim, Oh Joon Kwon, Jang Hee Park, Yeo Hoon Park

Published in: Surgical and Radiologic Anatomy | Issue 6/2016

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Abstract

Purpose

The aim of our study was to compare the difficulty in performing a posterior tympanotomy in chronic otitis media (COM) versus the same procedure in a normal mastoid.

Materials and methods

The study included 122 patients who underwent tympanomastoidectomy for unilateral chronic otitis media with contralateral normal mastoid pneumatization. We evaluated the anatomical relationships between the mastoid segment and neighboring structures by analyzing axial temporal bone computed tomography scans. A vertical line (line A) was drawn tangential to the most lateral end of the posterior semicircular canal (point A). Three distances were measured: the distance (D1) between the point A and the most lateral end of the mastoid segment of the facial nerve (point B), the distance (D2) between the line A and the point B, and the distance (D3) between the point B and the posterior end of the bony annulus of the external auditory canal.

Results

The average measurements of D1 and D3 were 3.79 ± 0.55 and 2.63 ± 0.51 mm, respectively, in the normal mastoid ears and 3.47 ± 0.59 and 2.35 ± 0.44 mm, respectively, in the COM ears. The measurements of D1 and D3 were statistically shorter in the COM ears than in the normal ears.

Conclusions

These findings suggest that the facial recess in COM may be narrower than in a normal mastoid and that performing a posterior tympanotomy may be riskier in COM than in a normal mastoid due to the potential for injury to the neighboring structures and the facial nerve.
Literature
1.
Althaus SR (1978) Postoperative facial paralysis: the otologist’s dilemma. Laryngoscope 88:243–252CrossRefPubMed
2.
Aoki K, Esaki S, Honda Y, Tos M (1990) Effect of middle ear infection on pneumatization and growth of the mastoid process. An experimental study in pigs. Acta Otolaryngol 110:399–409PubMed
3.
Aslan A, Goktan C, Okumus M, Tarhan S, Unlu H (2001) Morphometric analysis of anatomical relationships of the facial nerve for mastoid surgery. J Laryngol Otol 115:447–449CrossRefPubMed
4.
Bance M, Erb J (2003) A reliable radiologic landmark for the facial nerve in axial temporal bone computed tomography scans. Otolaryngol Head Neck Surg 128:251–256CrossRefPubMed
5.
Bennett M, Warren F, Haynes D (2006) Indications and technique in mastoidectomy. Otolaryngol Clin N Am 39:1095–1113CrossRef
6.
Bielamowicz SA, Coker NJ, Jenkins HA, Igarashi M (1988) Surgical dimensions of the facial recess in adults and children. Arch Otolaryngol Head Neck Surg 114(5):534–537CrossRefPubMed
7.
Calli C, Pinar E, Oncel S, Tatar B, Tuncbilek MA (2010) Measurements of the facial recess anatomy: implications for sparing the facial nerve and chorda tympani during posterior tympantomy. Ear Nose Throat J 89:490–494PubMed
8.
Eby TL (1996) Development of the facial recess: implications for cochlear implantation. Laryngoscope 106(5 Pt 2 Suppl 80):1-7
9.
Eby TL, Nadol JB Jr (1986) Postnatal growth of the human temporal bone: implications for cochlear implants in children. Ann Otol Rhinol Laryngol 95(4 Pt 1):356–364CrossRefPubMed
10.
Green JD, Shelton C, Brackmann DE (1994) Iatrogenic facial nerve injury during otologic surgery. Laryngoscope 104:922–926PubMed
11.
Ichijo H, Hosokawa M, Shinkawa H (1996) The relationship between mastoid pneumatization and the position of the sigmoid sinus. Eur Arch Otorhinolaryngol 253:421–424CrossRefPubMed
12.
Jeon EJ, Jun BC, Song JN, Kim JE, Lee DH, Chang KH (2013) Surgical and radiologic anatomy of a cochleostomy produced via posterior tympanotomy for cochlear implantation based on three-dimensional reconstructed temporal bone CT images. Surg Radiol Anat 35:471–475CrossRefPubMed
13.
Kim CW, Oh SJ, Kim HS, Ha SH, Rho YS (2008) Analysis of axial temporal bone computed tomography scans for performing a safe posterior tympanotomy. Eur Arch Otorhinolaryngol 265:887–891CrossRefPubMed
14.
Lee DH, Jung MK, Yoo YH, Seo JH (2008) Analysis of unilateral sclerotic temporal bone: how does the sclerosis change the mastoid pneumatization morphologically in the temporal bone? Surg Radiol Anat 30:221–227CrossRefPubMed
15.
Luntz M, Malatskey S, Braun J (2000) The anatomic relationship between the second genu of the facial nerve and the incus: a high-resolution computed tomography study. Am J Otol 21:686–689PubMed
16.
Nilssen ELK, Wormald PJ (1997) Facial nerve palsy in mastoid surgery. J Laryngol Otol 111:113–116CrossRefPubMed
17.
Sheehy JL, Patterson DE (1967) Intact canal wall tympanoplasty with mastoidectomy. Laryngoscope 77:1502–1542CrossRefPubMed
18.
Teszler CB, Ruimi D, Bar-Meir E, Luntz M (2005) Width of the extended facial recess: a numerical study of ultrahigh-resolution computed tomography and its implications in minimally invasive otology surgery. Otol Neurotol 26:782–789CrossRefPubMed
19.
Thom JJ, Carlson ML, Olson MD, Neff BA, Beatty CW, Facer GW et al (2013) The prevalence and clinical course of facial nerve paralysis following cochlear implant surgery. Laryngoscope 123:1000–1004CrossRefPubMed
20.
Turgut S, Tos M (1992) Correlation between temporal bone pneumatization, location of lateral sinus and length of the mastoid process. J Laryngol Otol 106:485–489CrossRefPubMed
Metadata
Title
Posterior tympanotomy is a riskier procedure in chronic otitis media than in a normal mastoid: a high-resolution computed tomography study
Authors
Chang Woo Kim
Oh Joon Kwon
Jang Hee Park
Yeo Hoon Park
Publication date
01-08-2016
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 6/2016
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-015-1606-5

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