Selective epitympanic dysventilation syndrome

Marchioni, Daniele; Alicandri‐Ciufelli, Matteo; Molteni, Gabriele; Artioli, Franca Laura; Genovese, Elisabetta; Presutti, Livio

doi:10.1002/lary.20841

Cited by 87 publications

(71 citation statements)

References 10 publications

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“…This is particularly true when considering the tensor fold. Because of the location and orientation of this fold, it is a structure that can not be seen through traditional microscopic transcanal and transmastoid approaches to the anterior attic [13]. The only exception is a determined look for this structure through a widely opened facial recess, and only after removal of incus.…”

Section: Discussionmentioning

confidence: 99%

“…It remains to be seen if this diaphragm is the anatomic basis for the retraction and cholesteatoma in the attic in ears with no disease within the mesotympanum. Marchioni and colleagues have recently described a ''selective dysventilation syndrome'' by using transcanal endoscopy to document the obstructive changes affecting the isthmus [13]. It remains to be seen if this anatomic orientation and the obstruction of the isthmus is the main reason for development of attic cholesteatoma.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Epitympanum Revisited: Endoscopic Anatomy

Tarabichi

Marchioni

Kapadia

2016

Indian J Otolaryngol Head Neck Surg

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In contrast to other means of studying the epitymapnum, the endoscope allows unparallel access without disruption of anatomy. The aim of this study is to delineate the anatomy of the epitympanum through transcanal endoscopy. Systematic dissection of anatomic specimens. We performed systematic endoscopic dissection of 20 ears in 10 fresh frozen anatomical specimens. A detailed flow sheet was filled up documenting the status of the lateral attic folds, the tensor fold, the cog and the tensor folds, the supratubal recess, and the patency of the anterior and posterior isthmus. None of the ears showed indication of previous chronic otitis media. The lateral incudomallear fold was intact in all but one ear. The lateral mallear fold was intact in all specimens. The tensor fold was complete in 16 ears and partial in four. Two of these ears belonged to the same specimen. The epitympanic diaphragm was complete in 15 out of 20 ears in 10 anatomic specimens. The endoscope allows for assessment of the attic anatomy and integrity of the diaphragm without undue disruption of anatomy. The epitympanic diaphragm is present in the majority of healthy ears and can in theory serve as the anatomic basis for the isolated attic retraction.Keywords Epitympanum 1 Á Endoscopic ear surgery 2 Á Lateral incudomallear fold 3 Á Lateral mallear fold 4 Á Tensor fold 5 Á Epitympanic diaphragm 6

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Epitympanum Revisited: Endoscopic Anatomy

Tarabichi

Marchioni

Kapadia

2016

Indian J Otolaryngol Head Neck Surg

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“…Blockage causing the insufficient ventilation to mastoid and epitympanum could be anywhere in its ventilation pathway and could be independent of eustachian tube function. Marchioni et al in their study introduced with a condition known as selective epitympanic dysventilation syndrome comprising epitympanic dysventilation along with attic retraction and cholesteatoma even in presence of normal eustachian tube function 4 . This is also evident in studies that anterior tympanostomy tube was of no use in treatment of the attic retraction.…”

Section: Discussionmentioning

confidence: 99%

Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Kamal¹

2014

Bangla J. Endosurg.

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Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum. Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes-assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum. Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum. Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

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“…These papers bring about a new approach for known disorders, such as the cholesteatoma, introducing new physiological and anatomical concepts concerning aeration of the tympanic cavity and mastoid cells in order to understand the disease and its surgical treatment [7][8][9] . Today, the endoscope plays an important role in cholesteatoma surgery in some centers in the world; however, there are still very few papers in the literature discussing the possible benefits of stapes surgeries made solely with the use of the endoscope, especially those studies based on the exposure of the oval window niche and stapes visibility.…”

Section: Discussionmentioning

confidence: 99%

Estapedotomia totalmente endoscópica: técnica e resultados preliminares

Júnior¹,

Martins²,

Aguiar³

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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St apedotomies are perfomed with the aid of surgical microscopes. However, the microscope has some limitations and may cause complications such as damage to the chorda tympani nerve. There are just a few cases and no series published on the use of sino-nasal endoscopes in stapedotomies.Objectives: a) To investigate the feasibility of using sino-nasal endoscopes in stapedotomies, focusing on the visualization of important structures. b) To show initial results, discuss possible advantages and disadvantages of this instrument.Methods: 15 patients with otosclerosis were selected to undergo stapedotomies in 2010. The data and surgery videos were analyzed retrospectively (study case series). The anatomical conditions of the oval window niche and surgical steps were described and used to assess possible benefits of such procedures. Results:The surgeries were performed with endoscopes only and all relevant anatomical structures were visualized without difficulty. No complications were observed and 14 of the 15 patients reported improvement of their hearing, confirmed by postoperative audiological tests. Conclusion:Totally endoscopic stapes surgeries are technically feasible, safe and promising. In this small series, the main advantages were: virtually no trauma to the chorda tympani nerve and excellent vision. The disadvantages were the lack of stereoscopic vision, having to work with one hand only and the learning curve. Braz J Otorhinolaryngol. 2011;77(6):721-7. ORIGINAL ARTICLE BJORL

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Selective epitympanic dysventilation syndrome

Cited by 87 publications

References 10 publications

The Epitympanum Revisited: Endoscopic Anatomy

The Epitympanum Revisited: Endoscopic Anatomy

Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Estapedotomia totalmente endoscópica: técnica e resultados preliminares

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