Inserm, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, Besançon, University of Bourgogne Franche-Comté, Besançon, France.
Inserm, Regenerative Nanomedicine Laboratory, UMR 1260, Laboratory of Engineering Science, Computer Science and Imaging, CNRS, Department of Maxillofacial and Plastic Surgery, Faculty of Medicine, ICUBE University of Strasbourg, University Hospital and UFR Medicine of Strasbourg, Strasbourg, France.
J Stomatol Oral Maxillofac Surg. 2020 Nov;121(5):545-549. doi: 10.1016/j.jormas.2020.04.005. Epub 2020 Apr 30.
Defects affecting the anterior wall of the tympanal bone can result from trauma, infection, neoplasm or previous local surgery. An anatomic variation, namely the persistence of the foramen tympanicum, can also be encountered. When symptomatic, surgical reconstruction may be indicated. The aim of this study was to identify the surgical treatments of symptomatic foramen tympanicum found in the literature and detail our innovative reconstruction technique. A bibliographic research was conducted in PubMed database in March 2020, without time limitation. Papers dealing with surgical management of a foramen tympanicum were included. Data collected were the publication date, the number of patients, their age and gender, the symptoms and the surgical treatment performed. We report, in addition, the case of a symptomatic persistent foramen tympanicum in a 30-year-old man with a follow-up of 18-months. A total of 17 studies (n=23 patients) were included for analysis. The main reconstruction techniques were, in equal proportion, cartilage graft (30%) and insertion of a titanium mesh (30%). We carried out an iliac crest bone graft using a preauricular approach on a patient suffering from chronic tinnitus and fullness in the left ear resulting from a persistent foramen tympanicum, confirmed by clinical and radiological examinations. It allowed the complete resolution of symptoms and no complication such as temporomandibular ankylosis occurred. Based on the review of the literature, we believe this technique has the advantage of providing durable reconstruction thanks to osseointegration.
影响鼓室前壁的缺陷可能由创伤、感染、肿瘤或先前的局部手术引起。也可能遇到解剖变异，即鼓室孔的持续存在。当出现症状时，可能需要进行手术重建。本研究的目的是确定文献中报道的有症状的鼓室孔的手术治疗方法，并详细介绍我们的创新重建技术。我们于 2020 年 3 月在 PubMed 数据库中进行了文献检索，没有时间限制。纳入的文献为涉及鼓室孔手术治疗的文章。收集的数据包括出版日期、患者数量、年龄和性别、症状以及实施的手术治疗。此外，我们还报告了一名 30 岁男性有症状的持续性鼓室孔病例，随访 18 个月。共有 17 项研究（n=23 例患者）纳入分析。主要的重建技术包括软骨移植（30%）和钛网插入（30%）。我们对一名因持续性鼓室孔而出现左侧耳朵慢性耳鸣和饱满感的患者进行了髂嵴骨移植，该患者通过临床和影像学检查得到证实。该手术完全缓解了症状，没有出现颞下颌关节强直等并发症。基于文献复习，我们认为该技术具有优势，可通过骨整合提供持久的重建。
