Anatomical Variations in Chronic Otitis Media Surgery; Comparison of Tomography and Perioperative Findings
Abstract
Aim: For a correct and adequate chronic otitis media surgery, it is necessary to correctly define the anatomical structures and to know their possible variations, otherwise, an increase in the complication rate is inevitable. This study aims to present the anatomical variations detected both in preoperative computerized tomography scanning and during operation, and complication rates encountered in 308 patients who underwent tympanomastoidectomy due to chronic otitis media in the light of current literature knowledge.
Materials and Methods: In this retrospective study, the files of 308 patients who underwent tympanomastoidectomy due to chronic otitis media in a tertiary clinic between September 2011 and July 2019 were scanned for encountered anatomical variations detected both in preoperative computerized tomography scanning and during operation and complications.
Results: There was Körner septum in 12 (3.8%) cases, dehiscence in the facial nerve tympanic segment in 12 (3.8%) cases, and lateral semicircular canal dehiscence (LSCD) in 4 (1.3%) cases. In 4 (1.3%) cases, it was observed that the dura was located downward and in 6 (1.9%) cases, the sigmoid vein was located anterosuperiorly.
Conclusion: Always being careful in terms of anatomical variations and possible complications during the operation will increase the success of the surgery. Knowing the anatomical variations and complications related to the temporal region is of great importance for clinicians dealing with ear surgery.
References
- 1. Mittal R, Lisi C V, Gerring R, Mittal, J, Mathee K, Narasimhan G, et. al.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J. Med. Microbiol 2015;64(10):1103–16.
- 2. Singh B, Maharaj TJ. Radical mastoidectomy: its place in otitic intracranial complications. J Laryngol Otol 1993;107:1113-8.
- 3. Aydil U, Köksal A, Özçelik T, Özgirgin N. Comparison of reformatted 2 D images with 3 D reconstructions based on images from multi-detector CT of the temporal bone in operated COM patients. Int Adv Otol 2010;6:337-41.
- 4. Qureishi A, Lee, Y, Belfield K, Birchall JP, Daniel M. Update on otitis media - prevention and treatment. Infect Drug Resist 2014;7:15–24.
- 5. Kurihara A, Toshima M, Yuasa R, Takasaka T. Bone destruction mechanisms in chronic otitis media with cholesteatoma: specific production by cholesteatoma tissue in culture of bone-resorbing activity attributable to interleukin -1 alpha. Ann Otol Rhinol Laryngol 1991;100(12):989 -98.
- 6. Macri JR, Chole RA. Bone Erosion in Experimental Cholesteatoma- the Effect of Implanted Barriers. Otolaryngol Head Neck Surg 1985;93(1):3-16.
- 7. Tos M, editor.In: Manual of middle ear surgery. New York, Thieme Medical Publishers;1995 pp 50–61.
- 8. Proctor B, Nielson E, Proctor C. Petrosquamosal suture and lamina. Otolaryngol Head Neck Surg 1981;89:124-9.
- 9. Djeric D, Savic D. Otogenic facial paralysis: A histopathological study. Eur Arch Otorhinolaryngol 1990;247:143-6.
- 10.Sezgi̇n Z , Külekçi̇ M . Kronik Otitis Mediada Kulak Zarı Perforasyonları ve Kemik Zincir Patolojileri ile İşitme Kayıpları arasındaki İlişki. J Contemp Med 2016; 6(4): 266-76.
- 11. Sheehy JL, Brackmann DE, Graham MD. Cholesteatoma surgery: residual and recurrent disease. A review of 1,024 cases. Ann. Otol. Rhinol 1977;86(4 Pt 1):451–62.
- 12. Singh A, Thakur R, Kumar R, Verma H, Irugu D. Grading of the Position of the Mastoid Tegmen in Human Temporal Bones - A Surgeon's Perspective. J Int Adv Otol 2020; 16(1):63–6.
- 13. Walshe P, McConn Walsh R, Brennan P, Walsh M. The role of computerized tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol Allied Sci 2002;27:95-7.
- 14. Kizilay A, Aladag I, Cokkeser Y, Ozturan O. Dural bone defects and encephalocele associated with chronic otitis media or its surgery. Kulak Burun Bogaz Ihtis Derg 2002;9(6):403–9.
Kronik Otitis Media Cerrahisinde Anatomik Varyasyonlar; Tomografi ve Perioperatif Bulguların Karşılaştırılması
Abstract
Amaç: Doğru ve yeterli bir kronik otitis media cerrahisi için anatomik yapıların doğru tanımlanması ve olası varyasyonlarının bilinmesi gereklidir, aksi takdirde komplikasyon oranının artması kaçınılmazdır. Bu çalışmada hem preoperatif bilgisayarlı tomografi taramasında hem de operasyon sırasında saptanan anatomik varyasyonları ve kronik otitis media nedeniyle timpanomastoidektomi uygulanan 308 hastada karşılaşılan komplikasyon oranlarını güncel literatür bilgileri ışığında sunmayı amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışmada, Eylül 2011-Temmuz 2019 tarihleri arasında üçüncü basamak bir klinikte kronik otitis media nedeniyle timpanomastoidektomi uygulanan 308 hastanın dosyaları, karşılaşılan anatomik varyasyonlar açısından hem ameliyat öncesi bilgisayarlı tomografi taramasında hem de ameliyat sırasında not edilen bulgular ve komplikasyonlar açısından tarandı. .
Bulgular: 12 (% 3.8) olguda Körner septum, 12 (% 3.8) olguda timpanik segmentte fasiyal dehissans ve 4 (% 1.3) olguda lateral semisirküler kanal dehissansı (LSCD) vardı. 4 (% 1.3) olguda duranın aşağı, 6 (% 1.9) olguda sigmoid venin anterosuperior yerleşimli olduğu görüldü.
Sonuç: Operasyon sırasında anatomik varyasyonlar ve olası komplikasyonlar açısından her zaman dikkatli olmak ameliyatın başarısını artıracaktır. Temporal bölgeyle ilgili anatomik varyasyonların ve komplikasyonların bilinmesi kulak cerrahisi ile uğraşan klinisyenler için büyük önem taşımaktadır.
References
- 1. Mittal R, Lisi C V, Gerring R, Mittal, J, Mathee K, Narasimhan G, et. al.Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J. Med. Microbiol 2015;64(10):1103–16.
- 2. Singh B, Maharaj TJ. Radical mastoidectomy: its place in otitic intracranial complications. J Laryngol Otol 1993;107:1113-8.
- 3. Aydil U, Köksal A, Özçelik T, Özgirgin N. Comparison of reformatted 2 D images with 3 D reconstructions based on images from multi-detector CT of the temporal bone in operated COM patients. Int Adv Otol 2010;6:337-41.
- 4. Qureishi A, Lee, Y, Belfield K, Birchall JP, Daniel M. Update on otitis media - prevention and treatment. Infect Drug Resist 2014;7:15–24.
- 5. Kurihara A, Toshima M, Yuasa R, Takasaka T. Bone destruction mechanisms in chronic otitis media with cholesteatoma: specific production by cholesteatoma tissue in culture of bone-resorbing activity attributable to interleukin -1 alpha. Ann Otol Rhinol Laryngol 1991;100(12):989 -98.
- 6. Macri JR, Chole RA. Bone Erosion in Experimental Cholesteatoma- the Effect of Implanted Barriers. Otolaryngol Head Neck Surg 1985;93(1):3-16.
- 7. Tos M, editor.In: Manual of middle ear surgery. New York, Thieme Medical Publishers;1995 pp 50–61.
- 8. Proctor B, Nielson E, Proctor C. Petrosquamosal suture and lamina. Otolaryngol Head Neck Surg 1981;89:124-9.
- 9. Djeric D, Savic D. Otogenic facial paralysis: A histopathological study. Eur Arch Otorhinolaryngol 1990;247:143-6.
- 10.Sezgi̇n Z , Külekçi̇ M . Kronik Otitis Mediada Kulak Zarı Perforasyonları ve Kemik Zincir Patolojileri ile İşitme Kayıpları arasındaki İlişki. J Contemp Med 2016; 6(4): 266-76.
- 11. Sheehy JL, Brackmann DE, Graham MD. Cholesteatoma surgery: residual and recurrent disease. A review of 1,024 cases. Ann. Otol. Rhinol 1977;86(4 Pt 1):451–62.
- 12. Singh A, Thakur R, Kumar R, Verma H, Irugu D. Grading of the Position of the Mastoid Tegmen in Human Temporal Bones - A Surgeon's Perspective. J Int Adv Otol 2020; 16(1):63–6.
- 13. Walshe P, McConn Walsh R, Brennan P, Walsh M. The role of computerized tomography in the preoperative assessment of chronic suppurative otitis media. Clin Otolaryngol Allied Sci 2002;27:95-7.
- 14. Kizilay A, Aladag I, Cokkeser Y, Ozturan O. Dural bone defects and encephalocele associated with chronic otitis media or its surgery. Kulak Burun Bogaz Ihtis Derg 2002;9(6):403–9.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | January 15, 2022 |
| Acceptance Date | October 12, 2021 |
| Published in Issue | Year 2022 Volume: 12 Issue: 1 |
