Universidad Autonoma de Nuevo Leon, Facultad de Medicina, Human Anatomy Department, Monterrey, Nuevo Leon, Mexico.
Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Otorhinolaryngology Department, Monterrey, Nuevo Leon, Mexico.
Eur Arch Otorhinolaryngol. 2020 Oct;277(10):2681-2686. doi: 10.1007/s00405-020-06013-8. Epub 2020 May 7.
The facial nerve is the most vulnerable structure during otological surgeries. Facial canal dehiscence (FCD) is the main risk factor for iatrogenic injuries. Its prevalence in clinical studies ranges between 6 and 33.3%, while anatomical studies report 25-57%. The objective was to determine the prevalence of FCD stratified by age and gender in a healthy population.
Temporal bones from high-resolution computed tomography (CT) were analyzed. Patients with a history of trauma or tumors of the temporal bone, cholesteatomas, chronic middle ear disease, and any pathology that could modify the bone's anatomy, were excluded.
A total of 184 temporal bones were included. FCD was observed in 94 (51.2%) of the analyzed bones. The tympanic portion was the most frequently affected site with 91 (49.5%), followed by the mastoid segment with 3 (1.6%). No dehiscence was found in the labyrinth portion. We observed 30 (31.9%) of the FCD involved the oval window. Other bone defects identified with the FCD included: 11 (11.7%) with a lateral semicircular canal fistula and 7 (7.4%) with tegmen tympani erosions.
FCD has a high prevalence among healthy patients. A pre-surgical otological evaluation using high-resolution CT should be indicated to properly assess the patient and reduce the risk of injury.
面神经是耳部手术中最易受损的结构。耳骨管（FCD）是医源性损伤的主要危险因素。在临床研究中，其患病率在 6%至 33.3%之间，而解剖学研究报告为 25-57%。本研究的目的是确定健康人群中 FCD 的患病率与年龄和性别之间的关系。
对高分辨率 CT 的颞骨进行分析。排除颞骨外伤或肿瘤、胆脂瘤、慢性中耳疾病病史，以及任何可能改变骨解剖结构的病理学患者。
共纳入 184 例颞骨。分析的骨中，有 94 例（51.2%）存在 FCD。其中鼓室段受累最常见，有 91 例（49.5%），其次是乳突段有 3 例（1.6%）。迷路段未见 FCD。我们观察到 30 例（31.9%）FCD 累及卵圆窗。与 FCD 相关的其他骨缺损包括：11 例（11.7%）外侧半规管瘘和 7 例（7.4%）鼓室盖侵蚀。
FCD 在健康患者中患病率较高。术前应使用高分辨率 CT 进行耳科学评估，以正确评估患者并降低损伤风险。
