Kalcioglu M Tayyar, Kilic Osman, Tuysuz Ozan, Serifler Serkan, Tekin Muhammet
Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2019 Jan;276(1):79-83. doi: 10.1007/s00405-018-5198-7. Epub 2018 Nov 12.
This study aimed to investigate the rate and location of facial canal dehiscence (FCD) observed during surgery for chronic otitis media (COM) with or without cholesteatoma.
Operative details of 1296 patients who underwent chronic otitis media surgery from January 2000 to January 2017 by the same surgeon were included in this retrospective study focusing on intraoperative observations of FCD.
Because of the type of the surgery, the Fallopian canal could not be seen completely, so 924 of the cases which only involved performing a tympanoplasty were not included in the study. A total of 372 patients (196 males and 176 females) who had a canal wall down (CWD) or canal wall up (CWU) mastoidectomy were included in the study. A CWD mastoidectomy was performed on 250 patients, while 122 patients underwent a CWU mastoidectomy. The prevalence of FCD was 11.29% (42/372 patients). The dehiscence was more common in patients with cholesteatoma (n = 37; 88.1%) than those with non-cholesteatoma (n = 5; 11.9%). The tympanic segment (n = 32; 76.19%) was the most common location for FCD. When we compared the ossicular erosion results of the cases that had FCD, erosion in three ossicles together was more statistically significantly frequent than the other possibilities.
It is possible to see FCD because of COM, especially with cholesteatoma. FCD is most commonly seen around the oval window. If stapes or all three ossicles are eroded, the surgeons must be more careful regarding FCD to be more effective in preventing facial nerve damage.
本研究旨在调查在伴有或不伴有胆脂瘤的慢性中耳炎(COM)手术过程中观察到的面神经管裂(FCD)的发生率和位置。
本回顾性研究纳入了2000年1月至2017年1月间由同一位外科医生进行慢性中耳炎手术的1296例患者的手术细节,重点关注FCD的术中观察情况。
由于手术类型的原因,无法完全看到面神经管,因此仅进行鼓膜成形术的924例病例未纳入研究。本研究共纳入372例进行了开放式(CWD)或完壁式(CWU)乳突切除术的患者(196例男性和176例女性)。250例患者进行了开放式乳突切除术,122例患者进行了完壁式乳突切除术。FCD的发生率为11.29%(42/372例患者)。胆脂瘤患者中FCD更常见(n = 37;88.1%),而非胆脂瘤患者中FCD较少见(n = 5;11.9%)。鼓室段(n = 32;76.19%)是FCD最常见的位置。当我们比较发生FCD病例的听骨侵蚀结果时,三块听骨同时侵蚀在统计学上比其他情况更常见。
由于COM,尤其是伴有胆脂瘤时,有可能出现FCD。FCD最常见于卵圆窗周围。如果镫骨或所有三块听骨被侵蚀,外科医生在处理FCD时必须更加小心,以更有效地预防面神经损伤。