The posterior ligament of the incus (“white dot”): A reliable surgical landmark for the facial recess

McMillan, Ryan A.; Nassiri, Ashley M.; Leonel, Luciano; Rezende, Natalia; Celda, María Peris; Sweeney, Alex D.; Carlson, Matthew L.

doi:10.1016/j.amjoto.2021.103304

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…The results of this study suggest that cadaveric temporal bone dissections are an important part of the training of otolaryngology residents. These dissections provide surgeons with the opportunity to develop the skills and knowledge necessary to perform CM and PT safely and effectively [1,8,9]. The findings of this study also suggest that experience with cadaveric temporal bone dissections is associated with a lower risk of making errors during CM and PT.…”

Section: Discussionmentioning

confidence: 69%

“…These complications can not only compromise the intended surgical outcome but also pose a threat to patient safety [5][6][7]. Therefore, to perform these procedures safely and effectively, surgeons must have strong training and a wide knowledge of friendly landmarks before performing operations on live patients [1,8,9]. This study aimed to identify common mistakes and critical passages during the steps of temporal bone dissection among residents.…”

Section: Introductionmentioning

confidence: 99%

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Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Motta,

Massimilla,

Allosso

et al. 2024

JPM

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Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear surgery, which includes the management of inflammatory pathology, hearing rehabilitation, and also cognitive decline prevention surgery. The primary objective of this study was to identify common mistakes and critical passages during the initial steps of temporal bone dissection, specifically cortical mastoidectomy and posterior tympanotomy. Methods: A survey among 100 ENT residents was conducted, gathering insights into the most prevalent errors encountered during their training to uncover the most challenging aspects faced by novice surgeons during these procedures. Results: The most common mistakes included opening the dura of the middle cranial fossa (MCF), injury of the sigmoid sinus (SS), chorda tympani (CT), and facial nerve (FN) injury while performing the posterior tympanotomy. The most important critical steps to prevent mistakes are related to the absence of wide exposure during cortical mastoidectomy and the consequent impossibility of identifying the landmarks of the facial recess before performing posterior tympanotomy. Injury of these structures was more common in younger surgeons and in the ones who performed less than five temporal bone dissection courses. Conclusions: Numerous temporal bone dissections on cadavers are mandatory for ENT residents looking forward to performing middle ear surgery.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Motta,

Massimilla,

Allosso

et al. 2024

JPM

View full text Add to dashboard Cite

show abstract

“…An anatomical study of the temporal bone specimens by McMillan et al 19 reported that the mean distance between the CTN and the facial nerve was 3.3 mm at the level of the oval window and 2.4 mm at the level of the round window. Posterior tympanotomy can provide sufficient working space to operate around the I‐S joint.…”

Section: Discussionmentioning

confidence: 99%

Change in chorda tympani nerve function after two‐stage tympanoplasty for cholesteatoma

Nishimura

Miuchi

Ikehata³

et al. 2022

Laryngoscope Investig Oto

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Objectives: Chorda tympani nerve (CTN) function may be damaged more by two-stage than by one-stage surgery for middle ear cholesteatoma. However, few studies have reported the relationship between two-stage cholesteatoma surgery and CTN function.This study aimed to investigate CTN function after two-stage surgery for cholesteatoma.Methods: In this prospective study, 35 patients underwent two-stage canal wall up tympanoplasty (CWUT). Perioperative CTN function was assessed using questionnaires and electrogustometry (EGM). Participants were categorized into minor, major, and section groups, based on the degree of CTN manipulation during surgery.Results: In the first-stage surgery, posterior tympanotomy with an intact canal wall reduced the degree of CTN manipulation. The incidence of taste disorder after the first-stage surgery was 71.4%. Postoperative taste disorder and the EGM threshold improved early in the minor manipulation group. In the second-stage surgery, no new CTN damage occurred, even if this surgery involved removal of residual cholesteatoma. The incidence of taste disorder after second-stage surgery was less than that after first-stage surgery, independent of CTN preservation. However, the recovery rate of the EGM threshold after second-stage surgery was significantly lower in the section group than in those with CTN preservation. Conclusion:CTN function, including symptoms and EGM threshold, can be preserved during two-stage cholesteatoma surgery if care is taken to preserve the CTN in both the first-and second-stage surgeries. A two-stage CWUT, ensuring an intact bony annulus, may be effective to facilitate CTN preservation.

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Innovative computed tomography based mapping of the surgical posterior tympanotomy: An exploratory study

Vranken,

Schoovaerts,

Geerardyn

et al. 2024

Heliyon

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The posterior ligament of the incus (“white dot”): A reliable surgical landmark for the facial recess

Cited by 4 publications

References 19 publications

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Change in chorda tympani nerve function after two‐stage tympanoplasty for cholesteatoma

Innovative computed tomography based mapping of the surgical posterior tympanotomy: An exploratory study

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