Wu Zhengong

and 5 more

Introduction: This prospective study aimed to evaluate the predictive value of high-resolution computed tomography (CT) scan of the temporal bone in predicting the degree of difficulty of stapes exposure during otomicrosurgery. Methods: Twenty-seven patients with chronic otitis media and conductive or mixed deafness who were scheduled to undergo otomicrosurgery were included in the study. The width of the external auditory canal bone, the stapes to the cone bulge, as well as the stapes to the tympanic sinus distance were measured to indicate stapes exposure difficulty, which was confirmed during operation and divided into hard-to-expose and easily-exposed groups. The differences between the groups were compared; statistically significant parameters were included in the logistic regression model. Statistical significance was set at P<0.05. Results: Coronary and horizontal CT measurements of the stapes to cone bulge distance were statistically significant between the two groups ( P<0.05 and P<0.01, respectively). The CT measurements of the stapes to tympanic sinus and the width of the external auditory canal bone were also statistically significant between the two groups ( P<0.05). Multivariate logistic regression analysis revealed that the bulge distance could be used as an independent predictor of the difficulty of stapes exposure. Conclusion: Preoperative high-resolution CT scans in the coronal and horizontal planes of the stapes to the cone ridge can provide a reference in predicting the difficulty of stapes exposure during otomicrosurgery and deserve further attention.

Jia Ke

and 4 more

Introduction: Extensive ossification over the semicircular canal is not common in the surgery of otitis media. This study aimed to reduce intraoperative and postoperative complications among patients with extensive ossification over the lateral semicircular canal and concomitant otitis media. Methods: The patients’ clinical data were retrospectively reviewed to determine the preoperative imaging characteristics of perilabyrinthine ossificans and key points of surgical operation. The data of 156 patients who underwent radical mastoidectomy or tympanoplasty between January 2016 and December 2018 due to chronic otitis media or cholesteatoma were reviewed. Seven patients with extensive ossification over the lateral semicircular canal were identified, and their preoperative imaging results, intraoperative procedures, and postoperative symptoms were evaluated. Results: The incidence of extensive ossification over the lateral semicircular canal among patients with chronic otitis media was 4.5% (7/156). Ossification occurred in the periphery of the lateral semicircular canal; the osseous tissue frequently fused with the osseous lateral semicircular canal, obscuring the boundaries between the two structures. A semicircular canal fistula was observed in two of the seven patients with extensive ossification over the lateral semicircular canal. The two patients underwent surgical patching or filling and symptomatic hormone treatment. Postoperative vertigo occurred in both patients and subsided within 1–3 months. There was no significant difference between preoperative and postoperative hearing thresholds. Conclusion: Extensive ossification over the lateral semicircular canal has a low incidence and may be discovered through preoperative imaging evaluation, enabling medical personnel to engage in adequate preoperative preparations. During the surgical procedure, navigational landmarks are required to determine the anatomical structures. The management of semicircular canal fistulas is essential to the reduction of intraoperative and postoperative complications.