The growth of the maxillary sinus continues until the 3rd decade in males and the 2nd decade in females. Therefore, a maxillary sinus operation affecting the bony structures before these ages might affect the development of the sinus and needs to be performed carefully.

The aim of this study was to investigate the usefulness of a three-dimensional (3D) reconstruction of computed tomography (CT) images in determining the anatomy and topographic relationship between various important structures. Using 40 ears from 20 patients with various otological diseases, a 3D reconstruction based on the image data from spiral high-resolution CT was performed by segmentation, volume-rendering and surface-rendering algorithms on a personal computer. The 3D display of the middle and inner ear structures was demonstrated in detail. Computer-assisted measurements, many of which could not be easily measured in vivo, of the reconstructed structures provided accurate anatomic details that improved the surgeon's understanding of spatial relationships. A 3D reconstruction of temporal bone CT might be useful for education and increasing understanding of the anatomical structures of the temporal bone. However, it will be necessary to confirm the correlation between the 3D reconstructed images and histological sections through a validation study.

Objective This paper describes the construction of portals for electrode placement during cochlear implantation and emphasises the utility of pre-operative temporal bone three-dimensional computed tomography. Methods Temporal bone three-dimensional computed tomography was used to plan portal creation for electrode insertion. Results Pre-operative temporal bone three-dimensional computed tomography can be used to determine the orientation of temporal bone structures, which is important for mastoidectomy, posterior tympanotomy and cochleostomy, and when using the round window approach. Conclusion It is essential to create appropriate portals (from the mastoid cortex to the cochlea) in a step-by-step manner, to ensure the safe insertion of electrodes into the scala tympani. Pre-operative three-dimensional temporal bone computed tomography is invaluable in this respect.

Tinnitus modulation by nonauditory stimuli has recently been described, such as eye gaze, muscle contractions, finger movement, cutaneous sensitivity in hands. As tinnitus patients often have myofascial trigger points, the objective is to investigate the ability of myofascial trigger points evoking tinnitus modulation. METHODS: Some 94 consecutive patients with tinnitus were searched for myofascial trigger points through a standardized digital pressure of nine muscles (infraspinatus, levator scapulae, trapezius, splenius capitis, scalenus, sternocleidomastoid, digastric, masseter, and temporalis) by the same professional. According to Travel and Simmons criteria, tinnitus modulation was considered as present when there was any immediate increase/decrease in the numeric scale from 0 to 10 for tinnitus loudness and/or changes in pitch during the palpation of each muscle, when compared to the score right before palpation. Such evaluation took place in a silent environment in order to allow easier perception of tinnitus modulation. RESULTS: Myofascial trigger points were present in 72.3% of tinnitus patients and 55.9% of them reported temporary tinnitus modulation during digital pressure of at least one muscle, mainly in masseter, splenius, sternocleidomastoid, and temporalis muscles. The analysis by muscles showed that tinnitus modulation was significantly higher ipsilateral to the trigger point subject to examination in 6 out of 9 muscles. Modulation was not related to age, gender, or laterality of tinnitus. CONCLUSIONS: Myofascial trigger points should also be considered as a type of stimulus that can often evoke tinnitus modulation, besides those already described in the literature.