ABSTRACT
OBJECTIVE: To investigate the feasibility of the retrofacial approach to the pediatric sinus tympani (ST). STUDY DESIGN AND SETTING: Five pediatric cholesteatoma cases, 10 pediatric and 24 adult normal specimens were studied retrospectively using high-resolution CT measurements in our university hospital. The normal pediatric and adult specimens also underwent temporal bone dissections. CT measurements included the depth (d-ST) and the width (w-ST) of ST, the distance (F-PSC) from the facial canal to the posterior semicircular canal, and the distance (P-ST) from the depth of ST on a line perpendicular to the F-PSC line. RESULTS: There were no significant differences in any measurements between pediatric and adult normal specimens and between pediatric diseased and normal specimens (P > 0.05). The retrofacial approach performed in pediatric specimens was no more complex than in adult specimens. F-PSC>3.0 mm and P-ST<2.0 mm provided an accessible approach to the pediatric ST. CONCLUSION: The retrofacial approach can be used in selected pediatric cases. SIGNIFICANCE: This approach plays its individual role to eradicate cholesteatoma in a difficult-to-reach pediatric ST. EBM RATING: B-2.
Subject(s)
Cholesteatoma, Middle Ear/diagnosis , Cholesteatoma, Middle Ear/surgery , Ear, Middle/diagnostic imaging , Otologic Surgical Procedures/methods , Temporal Bone/anatomy & histology , Tomography, X-Ray Computed/methods , Adult , Age Factors , Aged , Case-Control Studies , Child , Child, Preschool , Dissection , Ear, Middle/anatomy & histology , Ear, Middle/surgery , Feasibility Studies , Female , Humans , Male , Middle Aged , Probability , Reference Values , Retrospective Studies , Risk Factors , Sensitivity and Specificity , Temporal Bone/diagnostic imagingABSTRACT
OBJECTIVE: To apply CO2 laser assisted Ugo Fisch stapedotomy with artificial stapes prostheses and to observe its outcome. METHOD: Between October 2001 and June 2003, 24 patients with clinical diagnosis of otosclerosis were performed with CO2 laser assisted Ugo Fisch stapedotomy. Among them 14 were males and 10 were females with a age of 24-65 years (averaged 36.5 years). The preoperative air bone gap of speech frequency is 25.00 to 48.25 dB, with an average of 36.25 dB. Follow-up was done once two months until 6 months. The key techniques are: (1) first disarculate the incudostapedial joint; (2) 0.3 mm or 0.4 mm piston is selected according to the space between horizontal segment of facial nerve and the suprastructure of stapes; (3) fenestrate on the footplate, insert the piston before dealing with stapedial muscle tendon and suprastructure of stapes; (4) deal with stapedial muscle tendon and suprastructure of stapes with CO2 laser. RESULT: A postoperative air bone gap < or = 15 dB is achieved in 23 cases (95.8%), a postoperative air bone gap < or = 10 dB is achieved in 21 cases (87.5%), with a mean of 8.5 dB. The postoperative complication is slight, without sickness and vomit, and 22 patients could walk immediately after surgery. CONCLUSION: CO2 laser assisted stapedotomy is the first choice for treating otosclerosis, which is of significant outcome, high safety and slight postoperative complication.
Subject(s)
Laser Therapy , Otosclerosis/surgery , Stapes Surgery/methods , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Ossicular Prosthesis , Treatment OutcomeABSTRACT
OBJECTIVE: To explore early post-operative complications following surgery for chronic suppurative otitis media. METHOD: From Jan 1992 to July 2000, 291 cases of chronic suppurative otitis media have been treated in our department. 79 cases underwent myringoplasty, 82 cases tympanoplasty, 88 cases modified radical mastoidectomy and 42 cases radical mastoidectomy. RESULT: Facial nerve palsies occurred in 3 cases (1.03%), bone conduction threshold elevation occurred in 13 cases (4.47%), wound infection occurred in 11 cases (3.78%), 7 patients (2.41%) reported symptoms related with chorda tympani trauma, symptoms of jaw discomfort were reported by 7 patients (2.41%) and imbalance or vertigo by 13 patients(4.47%). CONCLUSION: The incidence of early complications of surgery for chronic suppurative otitis media in this report was similar to previous reports.
