Objectives: To study the feasibility of approaches in addressing the mastoid segment of facial nerve through transcanal route exclusively under endoscopic guidance and to verify the usefulness of the pyramidal eminence as a landmark. Study design: The prospective experimental study Setting: “Transcanal endoscopic temporal bone dissection lab” situated in the Surgiscope hospital, Chittagong, Bangladesh. Materials: 4 (Four) cadaveric temporal bones. Interventions: Two pure transcanal endoscopic approaches were applied to excavate the mastoid segment of facial nerve. In anterior-medial approach, the dissection was progressed from medial to the lateral direction through the retrotympanum focusing the anterior-medial side of the mastoid segment of facial nerve. Whereas in anterior-lateral approach, the dissection was progressed from lateral to the medial direction through the posterior canal wall focusing the anterior-lateral side of the mastoid segment of facial nerve. In both approaches, the pyramidal eminence was considered as an anatomical landmark to navigate the dissection for the excavation of the mastoid segment of facial nerve. Main outcome measures: The efficacy of each approach in respect of the complete excavation of the mastoid segment of facial nerve and the worthiness of the pyramidal eminence as the landmark for navigating the dissection. Results: In both transcanal endoscopic approaches, the entire mastoid segment of facial nerve could be exposed successfully. But in anterior-medial approach, the chorda tympani nerve was needed to be sacrificed. The search of the mastoid segment of facial nerve with the guidance of the pyramidal eminence was observed as effective and safe. Conclusion: The entire mastoid segment of facial nerve could be successfully addressed through transcanal route under pure endoscopic guidance. The pyramidal eminence has appeared as an important landmark for such endeavor. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 108-115
ObjectiveTo evaluate the necessity and effectiveness of a preplanned technique for drilling during transcanal endoscopic ear surgery.MethodsStudy design: Retrospective case series study from June 2011 to June 2015. Setting: Private tertiary care hospital. Patients: Eighty‐five ears of 78 patients, age ranging from 9 to 57 years underwent transcanal endoscopic drilling for various types of pathology in their middle and external ear. Interventions: Application of a preplanned technique for transcanal drilling in endoscopic ear surgery that involved short timed drilling with use of intermittent irrigation and suction. Every events of the procedure were done one after another with the single hand of the surgeon. An attachment providing protecting sheath around rotating burr was used during each time of drilling. Main outcomes measure: Efficacy of such drilling technique in single handed endoscopic ear surgery. Presence of any postoperative thermal injury of facial nerve and any lacerated injury of skin of external ear.ResultsThis preplanned technique was found suitable for transcanal endoscopic drilling with the single hand of the surgeon. Postoperative facial nerve palsy or laceration of skin of external ear was not noted in any patient.ConclusionAfter using the present technique, transcanal endoscopic drilling could be done easily and safely with single hand of the surgeon.
Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum. Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes-assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum. Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum. Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.