Cautionary Findings for the Presence of Facial Canal Dehiscence During Cholesteatoma Surgery

Şahin, Muammer Melih; Çayönü, Melih; Dinç, Ayşe Seçil Kayalı; Boynueğri, Süleyman; Barut, Fulya Eker; Eryılmaz, Adil

doi:10.1177/0145561319856886

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media 16 In our study, there is similar low incidence in the intact ossicular group (12.5%) and isolated incus erosion group (10.96%).…”

Section: Jiom Nepalsupporting

confidence: 71%

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous

Kharel

Shreepaili²,

Tripathi

et al. 2020

Journal of Institute of Medicine

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Introduction Chronic otitis media squamous is a gradually expanding destructive lesion and leads to complications by eroding the adjacent structures. Facial canal and ossicles are in close proximity in the middle ear space and they share the same pathogenesis of the bony erosion. Ossicular chain erosion found intraoperatively due to cholesteatoma, may suggest the likelihood of facial canal dehiscence. This study was conducted to assess the relationship between ossicular chain erosion and facial canal dehiscence in chronic otitis media squamous. MethodsIt is a retrospective chart review of patients who had mastoidectomy done for chronic otitis media squamous in Tribhuvan University Teaching Hospital from January 2014 to December 2018. The operative findings of facial canal dehiscence were correlated with ossicular chain status. ResultsAmong 158 cases, facial canal dehiscence was seen in 20 (12.7%), of which, 19/20 (95%) had ossicular erosion. Majority (90%) of dehiscence was in the horizontal segment. Incus was the most common ossicle to be eroded. Among the ossicles, stapes erosion was related to the facial canal dehiscence with odds ratio of 3.216 (1.235-8.374) and p-value 0.03. ConclusionAmong the ossicles, there is a relationship between the stapes erosion and the facial canal dehiscence in chronic otitis squamous. Erosion of ossicular chain especially stapes should alert surgeons towards the possibility of facial canal dehiscence.

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Section: Jiom Nepalsupporting

confidence: 71%

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous

Kharel

Shreepaili²,

Tripathi

et al. 2020

Journal of Institute of Medicine

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An evaluation of morphometry and dehiscence of facial canal: a systematic review and meta-analysis of observational studies

Asghar,

Priya,

Narayan

et al. 2024

Surg Radiol Anat

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A novel imaging scoring method for identifying facial canal dehiscence: an ultra-high-resolution CT study

Tang

Zhang²,

Zhao³

et al. 2022

Eur Radiol

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Objectives Facial canal dehiscence (FCD), typically found in the tympanic segment, is a risk factor for facial nerve injury. An imaging scoring method was proposed to identify FCD based on ultra-high-resolution CT. Methods Forty patients (21 females and 19 males, mean age 44.3 ± 17.4 years), whose tympanic facial canal (FC) was examined during otological surgery, were divided into the FCD group (n = 29) and the control group (n = 11) based on surgical findings. Imaging appearance of tympanic FC was scored 0–3: 0 = no evident bony covering, 1 = discontinuous bony covering with linear deficiency, 2 = discontinuous bony covering with dotted deficiency, and 3 = continuous bony covering. Both lateral and inferior walls were assigned a score as LFCD and IFCD, respectively. An FCD score was calculated as LFCD + IFCD. The diagnostic value of the FCD score was tested using the ROC curve. Results The inter-observer agreement was moderate for the lateral wall (Cohen’s κ coefficient 0.416, 95% CI 0.193–0.639), and good for the inferior wall (Cohen’s κ coefficient 0.702, 95% CI 0.516–0.888). In the FCD group, the most common appearance for both walls was discontinuous bony covering with linear deficiency (LFCD = 1, 22/29, 75.9%; IFCD = 1, 15/29, 51.7%). An FCD score of less than 4 was associated with high sensitivity (0.82) and specificity (0.93) for identifying FCD, with an AUC of 0.928. Conclusions Using the proposed scoring method, FCD score < 4 could identify FCD of the tympanic segment with high concordance with surgical findings. Key Points • Imaging appearance of the tympanic facial canal (FC) is divided into four types based on ultra-high-resolution CT images. • The most common appearance of FC with facial canal dehiscence (FCD) is discontinuous bony covering with linear deficiency. • An FCD score, consisting of scores of the lateral and inferior walls, less than 4 is highly indicative of FCD.

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Cautionary Findings for the Presence of Facial Canal Dehiscence During Cholesteatoma Surgery

Cited by 5 publications

References 17 publications

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous

An evaluation of morphometry and dehiscence of facial canal: a systematic review and meta-analysis of observational studies

A novel imaging scoring method for identifying facial canal dehiscence: an ultra-high-resolution CT study

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