Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Freiburgstrasse 15, 3010, Bern, Switzerland.
Department of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Eur Arch Otorhinolaryngol. 2023 Jan;280(1):131-136. doi: 10.1007/s00405-022-07465-w. Epub 2022 Jun 13.
This study aimed to investigate the variability of the retrotympanum in patients undergoing surgical treatment for cholesteatoma.
We included 59 ears of patients undergoing middle ear surgery for cholesteatoma who had preoperative computed tomography scans. A retrospective analysis of the medical records was conducted. The sinus tympani (ST), subtympanic sinus (STS) and facial recess (FR) were classified into types A-C based on the relationship of their extension to the facial nerve. The mastoid and petrous apex were assessed and categorized as normal pneumatized or sclerotic.
Type A extension was the most frequently found in all sinuses (ST 64%, FR 77%, STS 69%), Type B extension was found more often in ST (34%) and STS (24%) than in FR (15%). A very deep extension was found only rarely (ST 2%, FR 8%, STS 7%). A sclerotic mastoid was found in 67% of cases. Those cases showed a statistically significant difference regarding retrotympanum pneumatization when compared with normal mastoid.
The most frequent variant of retrotympanic pneumatization in relation to the facial nerve was type A in all subsites in cholesteatoma patients. The variability among patients with cholesteatoma is different to previously published results in healthy subjects. Moreover, the pneumatization of the retrotympanum is associated with mastoid pneumatization.
本研究旨在探讨接受胆脂瘤手术治疗的患者中后鼓室的变异性。
我们纳入了 59 例接受中耳胆脂瘤手术的患者的 59 耳，这些患者均有术前计算机断层扫描。对病历进行回顾性分析。根据与面神经关系的延伸，将鼓窦（ST）、下鼓室窦（STS）和面神经隐窝（FR）分为 A-C 型。评估并分类乳突和岩尖为正常气化或硬化。
所有窦（ST 64%，FR 77%，STS 69%）中最常见的是 A 型延伸，ST（34%）和 STS（24%）比 FR（15%）中更常见 B 型延伸。非常深的延伸很少见（ST 2%，FR 8%，STS 7%）。67%的病例发现乳突硬化。与正常乳突相比，这些病例在后鼓室充气方面存在统计学显著差异。
在胆脂瘤患者中，所有部位面神经后鼓室充气最常见的变异型是 A 型。胆脂瘤患者的变异与之前在健康受试者中发表的结果不同。此外，后鼓室充气与乳突充气有关。
