Çam Osman Halit, Karataş Mehmet
*Ear Nose and Throat Department, Ozel Kucukyali Delta Hospital, Istanbul †Ear Nose and Throat Department, Adiyaman University Training and Research Hospital, Adiyaman, Turkey.
J Craniofac Surg. 2015 Oct;26(7):e619-20. doi: 10.1097/SCS.0000000000002116.
The aim of this article is to imply the significance of temporal bone computed tomography imaging before temporal surgeries.
A 74-years-old patient was admitted to emergency department with dizziness and nausea. The neurologic examination showed a spontaneous nystagmus, whereas otologic examination revealed a left tympanic membrane perforation with mild discharge. A temporal bone computed tomography imaging was scheduled to exclude cholesteatoma and perilymphatic fistula. Computed tomography detected an anterior sigmoid sinus with middle fossa defect and subcutaneous course of the sinus in posterior-superior portion of the external ear canal skin with no cholesteatoma sign. Thus, Dix-Hallpike was performed on the patient and was positive on the right side. The patient was diagnosed as benign positional vertigo.
Sigmoid sinus is an important landmark in otologic surgeries and in some patients it may be problematic because of its dehiscence. To avoid any surgical complications it is highly important to evaluate a temporal bone computed tomography imaging before any transmastoid, retroauricular and edoaural surgeries.
本文旨在阐明颞骨手术前颞骨计算机断层扫描成像的重要性。
一名74岁患者因头晕和恶心入住急诊科。神经系统检查显示自发性眼球震颤，而耳科检查发现左侧鼓膜穿孔并有轻度分泌物。计划进行颞骨计算机断层扫描成像以排除胆脂瘤和外淋巴瘘。计算机断层扫描检测到乙状窦前位伴中颅窝缺损，外耳道皮肤后上部分有窦的皮下走行，无胆脂瘤迹象。因此，对该患者进行了 Dix-Hallpike 试验，右侧结果为阳性。该患者被诊断为良性阵发性位置性眩晕。
乙状窦是耳科手术中的重要标志，在某些患者中，由于其裂开可能会出现问题。为避免任何手术并发症，在进行任何经乳突、耳后和耳道手术前评估颞骨计算机断层扫描成像非常重要。
