Faramarzi Mohammad, Roosta Sareh
Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
Vice Chancellery of Research and Technology, Center for Development of Clinical Studies of Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Indian J Otolaryngol Head Neck Surg. 2017 Sep;69(3):300-306. doi: 10.1007/s12070-017-1094-5. Epub 2017 Feb 6.
The aim of this retrospective study was to determine the incidence of facial canal dehiscence (FCD) in primary and revision cholesteatoma surgery in a tertiary referral center. Moreover, our second goal was to identify association between FCD and other intra-operative pathological findings in a group of patients with cholesteatoma surgery. Inclusion criteria were primary and revision canal wall up and canal wall down tympanomastoidectomy in patients who suffers from chronic otitis media (COM) with cholesteatoma. An exclusion criterion was charts with in adequate documentation. In addition tympanoplasty cases were excluded due to evaluate both tympanic and mastoid segments of facial nerve canal. Preoperative clinical data and intra-operative findings were documented in a formatted questionnaire. We found the incidence of FCD in COM surgery was 18%. There was no difference between the primary and revision surgeries regarding its incidence. In addition, there was association between some preoperative or intra-operative findings of COM, such as middle fossa dural dehiscence, external auditory canal polyp, facial nerve paralysis, labyrinthine fistula, and FCD. In conclusions we found that there was no difference between primary and revision surgeries regarding the incidence of FCD. Surgeons should consider effective measures to prevent intra-operative facial nerve trauma in COM surgeries.
这项回顾性研究的目的是确定在一家三级转诊中心进行的原发性和翻修性胆脂瘤手术中面神经管裂开（FCD）的发生率。此外，我们的第二个目标是在一组接受胆脂瘤手术的患者中确定FCD与其他术中病理发现之间的关联。纳入标准为患有慢性中耳炎（COM）伴胆脂瘤的患者进行的原发性和翻修性外耳道上壁和外耳道下壁鼓室乳突切除术。排除标准是记录不充分的病历。此外，由于要评估面神经管的鼓室段和乳突段，鼓室成形术病例被排除。术前临床数据和术中发现记录在一份格式化问卷中。我们发现COM手术中FCD的发生率为18%。原发性手术和翻修性手术在其发生率方面没有差异。此外，COM的一些术前或术中发现，如中颅窝硬脑膜裂开、外耳道息肉、面神经麻痹、迷路瘘管和FCD之间存在关联。总之，我们发现原发性手术和翻修性手术在FCD发生率方面没有差异。外科医生应考虑采取有效措施，以防止COM手术中术中面神经损伤。
