A Spatial Index Analysis for Decision on the First Opening of Facial Recess in Posterior Tympanotomy

Kang, Jae Ho; Choi, Kyung Min; Han, Jang Hee; Kim, Choon Dong; Kim, Seung-Woo; Park, Sung Ho

doi:10.3342/kjorl-hns.2009.52.9.730

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…There have been only few reports to evaluate the relationships of FN and other structures in the temporal bone, but they dealt only with the anatomic status of the factors influencing the access to posterior mesotympanum. 10,11 Although posterior tympanotomy is performed successfully, the visibility through it may not be good to expose the stapes or the oval window niche fully. To remove the cholesteatoma sac around the stapes or locate the ossicular replacement prosthesis right onto the stapes or the oval window, it is very important to secure their view field through posterior tympanotomy.…”

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confidence: 99%

Anatomic Limitations of Posterior Tympanotomy

Dong-Hee

Kim

Seo

et al. 2012

Journal of Craniofacial Surgery

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To radiologically evaluate the anatomic factors that may determine the view field or the accessibility of the posterior tympanotomy into the posterior mesotympanum, a cohort of 30 patients with pneumatic mastoids and 30 patients with unilateral sclerotic mastoids were included. Anatomic relationships were evaluated according to 5 parameters. The reference parameter of the view field through posterior tympanotomy was the maximum view to the stapes area through posterior tympanotomy. Direct distance between the chorda tympani nerve and the facial nerve (FN) and angle between the cortex of the external auditory canal and the FN showed significant positive correlations in pneumatic and sclerotic mastoids. However, the location of the FN was negatively correlated with the maximum view to the stapes area through posterior tympanotomy only in pneumatic mastoids. In particular, the angle between the cortex of the external auditory canal and the FN showed the best correlation with the maximum view to the stapes area through posterior tympanotomy. The angle between the cortex of the external auditory canal and the FN was the most important anatomic determinant for visibility through posterior tympanotomy. This study suggests that pneumatic mastoids, but not sclerotic mastoids, may have a more complex relationship including more factors than those considered in this study. Although this study was performed radiologically, this study can present the insight to surgeons or radiologists.

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confidence: 99%

Anatomic Limitations of Posterior Tympanotomy

Dong-Hee

Kim

Seo

et al. 2012

Journal of Craniofacial Surgery

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“…These variations may also increase the likelihood of surgical complications as FN injury. 9,10 The FR anatomy has been an object of several past investigations. Jain et al 11 made an anatomical review on 35 cadavers without considering surgical circumstances like bleeding and mucosal thickening, the FN location, or the aeration of the FR.…”

Section: Discussionmentioning

confidence: 99%

“…Possible variations of the course of the FN and chorda tympani nerve, the take‐off point of the chorda tympani nerve, and the aeration of the FR increase the PT difficulty. These variations may also increase the likelihood of surgical complications as FN injury 9,10 …”

Section: Discussionmentioning

confidence: 99%

Radiological Analysis of the Facial Recess: Impact on Posterior Tympanotomy Difficulty During Pediatric Cochlear Implantation

Elzayat

Mandour

Elfarargy

et al. 2022

Otolaryngol.--head neck surg.

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Objectives We analyzed several radiological features of the facial recess to correlate them with the intraoperative findings to highlight the most reliable predictors of posterior tympanotomy difficulty. Study Design Retrospective observational cohort study. Setting Multicenter study at tertiary referral institutions. Methods We included 184 pediatric patients who underwent cochlear implantation through the posterior tympanotomy approach. The correlation was attempted between 8 radiological features in the preoperative high-resolution computed tomography scan and intraoperative surgical difficulty. Results Posterior tympanotomy was straightforward in 136 (73.9%) patients. In contrast, it was challenging in 48 (26.1%) patients. The facial recess was aerated in 74.5% of patients. The mean (SD) posterior tympanotomy depth was 3.98 (0.867) mm. The mean (SD) chorda-facial angle was 27.67° (3.406°). The mean (SD) chorda-facial to stylomastoid length was 3.898 (0.6304) mm. The mean (SD) facial nerve second genu angle was 94.54° (6.631)°. Deep-unaerated facial recess wall was associated with the most difficulty. There was a statistically significant difference in the unchallenging and challenging posterior tympanotomy groups regarding the surgical duration ( P < .0001). Conclusions According to this analytic study, the chorda-facial angle, the facial recess aeration, and the chorda-facial to stylomastoid length were respectively the strongest preoperative radiological predictors of the surgical difficulty of posterior tympanotomy during cochlear implantation. Chorda-facial angle <25.5° was associated with difficult posterior tympanotomy. The oblique parasagittal cut was essential for the radiological analysis of the facial recess.

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A Spatial Index Analysis for Decision on the First Opening of Facial Recess in Posterior Tympanotomy

Cited by 2 publications

References 13 publications

Anatomic Limitations of Posterior Tympanotomy

Anatomic Limitations of Posterior Tympanotomy

Radiological Analysis of the Facial Recess: Impact on Posterior Tympanotomy Difficulty During Pediatric Cochlear Implantation

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