The Role of Preoperative Computed Tomography of Temporal Bone in Atticotomy as a New Tool for Determining the Approach.

The temporal bone is a complex anatomical structure and so preoperatively computed tomography (CT) of the temporal bone is important for choice of the surgical procedure. In this study, evaluation of the surgical difficulty to conduct transmastoid atticotomy with the coronary cut of CT temporal bone. Additional, attic pathology intraoperative is evaluated. The current research is a retrospective study of 79 patients with chronic suppurative otitis media (safe type) with the preoperative opacity of the attic in CT temporal bone. The researcher correlates difficulty to do transmastoid attictomy with the distance in mm between the roof of external audiatory canal (EAC) and tegmen with ruler directly in the coronary cut of CT temporal bone at the the level of internal auditory canal (IAC). The researcher also compares attic pathology intraoperative with preoperative CT attic opacity. In group of surgically difficulty average distance between the superior wall of EAC and tegmen on preoperative CT at the level of IAC is 2-5 mm while distance in easily surgical approach is from 6 to 10 mm. 68.4%(54/79) of cases had pathology in attic in the form of granulation tissue in 50 cases and glue in 4 cases. Preoperative CT temporal bone is very important to detect atticotomy approach either transmastoid or transcanal, through measuring the distance in mm between the roof of EAC and tegmen with ruler directly in the coronal cut of CT temporal bone at the level of internal auditory canal. The opacity of the attic in Preoperative CT does not mean that there is a pathology in the attic.

Differential Diagnosis of Post Auricular Swelling with Mastoid Bone Involvement.

Post auricular swelling with mastoid bone involvement most commonly occurs as a cranial complication of chronic or acute suppurative otitis media. Aim of this study, to detect etiology of postauricular swelling with mastoid bone involvement. This is a retrospective study which was done on all patients whom underwent mastoidectomy for post auricular swelling with mastoid bone involved in El Minia University Hospital from January 2014 to June 2017. A total of 49 patients were identified in this study, 23 males and 26 females, their ages ranged 5-28 years old with a mean of 25.8 years old. Group A: these were 45 patients with a history of otorrhea (chronic suppurative otitis media), of 3 months to 4 years duration. Group B: these were four patients without any history of otorrhea. Two patients diagnosed as acute otitis media, one patient diagnosed as Langerhans cell histiocytosis and one patient diagnosed as fungal mastoiditis. Chronic suppurative otitis media is the most common causes of postauricular swelling. Langerhans cell histiocytosis of the temporal bone and fungal mastoiditis are considered a rare presentation of postauricular swelling.