Incus Fixation Due to Congenital Anomaly of Chorda Tympani

Kraus, P.; Ziv, Moshe

doi:10.3109/00016487109122494

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…According to our literature review, very few anatomic variants of the tympanic segment of the chorda have been reported so far. In one case, it lay in a bony canal crossing the middle ear, fixing the incus and leading to conductive hearing loss, and in another case, a lateral position was described in association with a malleolar congenital anomaly (16,17). Unilateral or bilateral duplication of the chorda tympani has also been reported (18).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Anatomy of the Chorda Tympani: Systematic Dissection, Novel Anatomic Classification, and Surgical Implications

Molinari

Yacoub

Alicandri‐Ciufelli

et al. 2021

Otology &Amp; Neurotology

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Hypothesis: A transcanal endoscopic approach enables visualization of the variable course of the chorda tympani inside the middle ear. Background: The chorda tympani is the longest intrapetrous branch of the facial nerve. Despite having been investigated in several studies, a description of its tympanic tract from an endoscopic point of view is lacking in the literature. Methods: We performed transcanal endoscopic dissections of 44 human cadaveric head and ear specimens. The entry point of the chorda tympani into the middle ear was classified into four categories according to its location, and as covered or dehiscent according to its appearance. The chordal eminence (CE) was defined as absent, shallow, intermediate, prominent, or fused, based on its shape and extension. The relationship of the chorda tympani to adjacent bony and ligamental structures was assessed. Results: The tympanic tract of the chorda tympani was divided into three portions. The periannular segment was dehiscent in 54.5% of specimens, with type II being the most frequent entry point configuration (52.3%). In the interossicular segment, the nerve consistently passed lateral to the incus and medial to the malleus. The course of the intrapetrous segment was independent from the conformation of the tensor fold and supratubal recess. Conclusion:The transcanal endoscopic approach allows a detailed description of tympanic segment of the chorda tympani. Novel anatomic classifications of the chorda tympani and CE are proposed herein to highlight their possible surgical implications during otologic procedures.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Anatomy of the Chorda Tympani: Systematic Dissection, Novel Anatomic Classification, and Surgical Implications

Molinari

Yacoub

Alicandri‐Ciufelli

et al. 2021

Otology &Amp; Neurotology

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“…In previous studies, an electromagnetic modality was used to demonstrate that stapes fixation resulted in an ABG at low frequencies (46,47). In a case report on a congenital anomaly, a patient with isolated incus fixation also exhibited an ABG at low frequencies (48). Moreover, experimental study showed that extensive stapes fixation reduces the stapes velocity, resulting in >35 dB as a measure of conductive hearing loss (49).…”

Section: Discussionmentioning

confidence: 99%

Radiological and Audiological Prediction for Ossicular Fixation in Chronic Otitis Media and Tympanic Membrane Perforation

Motegi

Yamamoto

Akutsu

et al. 2021

Otology &Amp; Neurotology

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Objectives: Recurrent middle-ear infection can lead to ossicular fixation, adversely affecting post-tympanoplasty hearing outcomes. Preoperative prediction of ossicular fixation remains challenging. We aimed to investigate potential predictors of ossicular fixation in patients with chronic otitis media. Study Design: Retrospective. Setting: Tertiary academic medical center. Patients: Patients with noncholesteatomatous chronic otitis media and tympanic membrane perforation, without ossicular discontinuities. Interventions: Diagnostic. Main Outcome Measures: The fixation of each ossicle was assessed during tympanoplasty. The impact of preoperative otoscopic findings, computed tomography (CT) features, and hearing levels on the prediction of ossicular fixation was evaluated using uni-and multivariable logistic regression analyses.Results: One hundred thirty-five patients were included. Soft-tissue density between the malleus head and the anterior wall (odds ratio, 3.789 [95% confidence interval, 1.177-12.196]; p ¼ 0.0255) and poor development of mastoid cells (16.826 [2.015-134.520]; p ¼ 0.0078) were independent predictors of malleus fixation. In addition, !50% tympanic membrane perforation (5.412 [1.908-15.353]; p ¼ 0.0015), poor development of mastoid cells (3.386 [1.039-11.034]; p ¼ 0.0431), and a !40-dB preoperative air-bone gap (ABG) at 500 ]; p ¼ 0.0029) were independent predictors of incus fixation. Soft-tissue density surrounding the stapes (18.833 [1.856-191.104]; p ¼ 0.0119) and a !40-dB preoperative ABG at 500 ; p ¼ 0.0138) were correlated with stapes fixation. Conclusions: The accurate prediction of ossicular fixation in patients with chronic otitis media based on CT features and the ABG may facilitate decision-making regarding the need for ossiculoplasty, possibly avoiding unnecessary manipulation or overlooking of fixation.

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“…A few anatomical variants of the tympanic segment of the chorda tympani have been described. Two cases have been reported of the chorda tympani lying in a transtympanic bony sheath, associated with conductive hearing loss 30 , 31 . Lateral displacement of the chorda tympani has been found in association with congenital deformity of the malleus 32 .…”

Section: Across the Tympanummentioning

confidence: 99%