Effect of mastoid bone pneumatization on the conformation and depth of the sinus tympani, a high-resolution computed tomography study

Baklacı, Deniz; Kuzucu, İhsan; Güler, İsmail; Akbal, Şeyda; Kum, Nurcan Yurtsever; Yildirim, Gulsum Kubra; Parlak, Selçuk; Kum, Rauf Oğuzhan; Özcan, Müge

doi:10.1007/s00276-019-02246-3

Cited by 16 publications

(17 citation statements)

References 20 publications

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“…Our study showed that dimensions of the tympanic sinus were highly variable. Both the width and depth of the sinus tympani were measured in numerous studies and in most of them the measurements are consistent with those in our series [ 1 , 3 , 6 , 7 , 9 , 13 , 18 , 20 – 23 , 26 ].…”

Section: Resultssupporting

confidence: 91%

“…Basing on the measurements in the current study, the tympanic sinus has a trough-shape; the middle part has the narrowest and deepest dimensions. Wang et al classified ST into three categories: the cup-shaped, the pear-shaped and the boot-shaped, the last one was presented only in patients 2.6 (0.9-6.1) Baklaci et al [3] 2019 HRCT -1.41 ± 0.68 (0.20-3.00) Bekci et al [4] 2020 3D CT --ST volume rise with petrous bone pneumatization Cheita et al [6] 2010 Cadaver 2.00 (1.24-2.76) 2.74 (0.5-6.2) Chen et al [7] 2005 HRCT 1.98 (± 0.71) 2.25 (± 0.91) Donaldson et al [9] 1970 Cadaver -3.75 Kumar et al [13] 2019 Cadaver 1-3 (mean 2.2) 5 (mean 1.72) Mazziotti et al [18] 2006 CT 2.50 (1.5-3.2) 3 (2.3-4.8) Niemczyk et al [20] 2003 Cadaver 2.23 (1.0-3.5) oval Ozturan et al [22] 1996 Cadaver 1.49 (0.49-3.87) 2.06 (± 0.60) Parlier-Cuau et al [23] 1998 HRCT -2.7 (1-9) Saito et al [26] 1971 Cavader 0.96-3.22 (mean 2.14) 2.93 (0.61-5.87) Wang et al [29] 2015 3D HRCT --Cup-shaped, the pear-shaped and the bootshaped with congenital aural atresia [29]. In the literature, the shape of sinus tympani was also described as oval [20] Nitek et al described in most cases the tympanic sinus as elliptical in shape and its long diameter lies in the vertical plane [21].…”

Section: Shapementioning

confidence: 99%

“…The depth of sinus tympani is considered to be the most relevant morphological data [ 17 ]. Radiological examination, such as computed tomography (CT) and high-resolution computed tomography (HRCT) are commonly used to investigate pathologies of the temporal bone [ 3 , 28 , 29 ]. Although the anatomy of the middle ear was well evaluated in histological studies [ 26 ], investigations based on radiological examination are less common to evaluate prevalence of normal anatomical variations [ 17 , 18 , 24 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

et al. 2021

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Purpose Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. In such a surgical strategy the electrode is placed in the round window’s region throughout posterior tympanotomy. Common accessible needle-shaped electrodes using is difficult in achieving intraoperative stabilization. The aim of the study is to assess the dimensions and shape of sinus tympani, basing on the micro computed tomography scans for purposes of establishing the possible new electrocochleography electrode shape. Materials and methods Sixteen fresh frozen cadaveric temporal bones were dissected. MicroCT measurements included the depth and the width of sinus tympani, width of facial canal with stapedius muscle chamber. Obtained data were analyzed statistically with the use of RStudio 1.3.959 software. Results The highest average width of sinus tympani amounted for 2.68 mm, depth measured at the round window plane for 3.19 mm. Width of facial canal with stapedius muscle chamber highest average values at the round window plane- 3.32 mm. The lowest average minimum and maximum values were calculated at the 1 mm above the round window plane. The highest average posterior tympanotomy width was 2.91 mm. Conclusions The shape of the tympanic sinus is like a trough with the narrowest and deepest dimensions in the middle part. The ST shape and dimensions should be taken into account in constructing the ECochG electrode, designed for optimal placement through posterior tympanotomy approach.

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Section: Resultssupporting

confidence: 91%

Section: Shapementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

et al. 2021

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“…Interestingly, impaired pneumatization of the mastoid appeared to be associated with a less pneumatized retrotympanum in our cohort, when comparing cholesteatoma patients with sclerotic mastoid spaces to those with pneumatized ones. These findings are in line with a recently published study which found the pneumatization of the mastoid of patients with chronic otitis media was associated with the depth of the sinus tympani only [15]. Our study found that this association applied to the facial recess and the subtympanic sinus as well.…”

Section: Discussionsupporting

confidence: 94%

Variability of the retrotympanum and its association with mastoid pneumatization in cholesteatoma patients

Hool

Beckmann

Hakim

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose This study aimed to investigate the variability of the retrotympanum in patients undergoing surgical treatment for cholesteatoma. Methods We included 59 ears of patients undergoing middle ear surgery for cholesteatoma who had preoperative computed tomography scans. A retrospective analysis of the medical records was conducted. The sinus tympani (ST), subtympanic sinus (STS) and facial recess (FR) were classified into types A–C based on the relationship of their extension to the facial nerve. The mastoid and petrous apex were assessed and categorized as normal pneumatized or sclerotic. Results Type A extension was the most frequently found in all sinuses (ST 64%, FR 77%, STS 69%), Type B extension was found more often in ST (34%) and STS (24%) than in FR (15%). A very deep extension was found only rarely (ST 2%, FR 8%, STS 7%). A sclerotic mastoid was found in 67% of cases. Those cases showed a statistically significant difference regarding retrotympanum pneumatization when compared with normal mastoid. Conclusion The most frequent variant of retrotympanic pneumatization in relation to the facial nerve was type A in all subsites in cholesteatoma patients. The variability among patients with cholesteatoma is different to previously published results in healthy subjects. Moreover, the pneumatization of the retrotympanum is associated with mastoid pneumatization.

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“…Furthermore, in this study, we investigated the individual anatomical differences of the tympanic sinus, the vertical portion of the facial nerve, and the jugular bulb as important structures during middle ear surgery. The tympanic sinus is the space behind the tympanum [10], a di cult-to-visualize area considered to be a clinically important structure because lesions tend to remain in this space [11].…”

Section: Discussionmentioning

confidence: 99%

Morphological relationships between external auditory canal and vital structures of tympanic cavity

Ohira

Komori

Nakamura

et al. 2022

Preprint

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Purpose: We aimed to evaluate the morphology of the external auditory canal (EAC) using a three-dimensional (3D) reconstruction of computed tomography (CT) scans of the temporal bone to corroborate and predict important anatomical structures involved in middle ear surgery based on the EAC morphology.Methods: Temporal bone CT from 62 patients (120 ears) was used to perform 3D reconstruction (maximum intensity projection), of which 32 patients (60 ears) had chronic otitis media and 30 patients (60 ears) had normal temporal bones. The anatomical morphology of the EAC, tympanic sinus, vertical portion of the facial nerve, and jugular bulb were measured, and the anatomical relationship between the EAC morphology and important structures of the middle ear was analyzed.Results: In ears with chronic otitis media, the overhang of the inferior wall of the EAC was significantly more than that in normal ears, and the antero-posterior length of the bony tympanic ring was short. Furthermore, the tympanic sinus was shallow, and vertical portion of the facial nerve tended to run outward. The EAC morphology correlated with the tympanic sinus depth and outward orientation of the vertical portion of the facial nerve.Conclusion: A severe overhang of the inferior wall of the EAC and short antero-posterior length of the bony tympanic ring indicates a higher possibility of a shallow tympanic sinus and an outward orientation of the vertical portion of the facial nerve. These findings aid in predicting the difficulty of tympanic sinus operation and reducing facial nerve damage risk during EAC excision.

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Effect of mastoid bone pneumatization on the conformation and depth of the sinus tympani, a high-resolution computed tomography study

Cited by 16 publications

References 20 publications

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

Variability of the retrotympanum and its association with mastoid pneumatization in cholesteatoma patients

Morphological relationships between external auditory canal and vital structures of tympanic cavity

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