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      Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

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          Abstract

          Introduction  Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications.

          Objective  This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma.

          Methods  We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal.

          Results  Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant ( p  < 0.05).

          Conclusion  Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

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          Most cited references11

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          The Dehiscent Facial Nerve Canal

          Accidental injury to the facial nerve where the bony canal defects are present may result with facial nerve dysfunction during otological surgery. Therefore, it is critical to know the incidence and the type of facial nerve dehiscences in the presence of normal development of the facial canal. The aim of this study is to review the site and the type of such bony defects in 144 patients operated for facial paralysis, myringoplasty, stapedotomy, middle ear exploration for sudden hearing loss, and so forth, other than chronic suppurative otitis media with or without cholesteatoma, middle ear tumors, and anomaly. Correlation of intraoperative findings with preoperative computerized tomography was also analyzed in 35 patients. Conclusively, one out of every 10 surgical cases may have dehiscence of the facial canal which has to be always borne in mind during surgical manipulation of the middle ear. Computerized tomography has some limitations to evaluate the dehiscent facial canal due to high false negative and positive rates.
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            Ossicular chain status in chronic suppurative otitis media in adults.

            This study was conducted to find out the status of the ossicles in cases of chronic suppurative otitis media (CSOM). One hundred and fifty cases of CSOM, who underwent surgery, were included and their intra-operative ossicular chain findings noted. Ossicular erosion was found to be much more common in unsafe CSOM than in safe CSOM. Malleus was found to be the most resistant ossicle to erosion whereas incus was found to be the most susceptible.
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              Facial canal dehiscence in the initial operation for chronic otitis media without cholesteatoma.

              To evaluate the risk of the facial nerve injury during operations for chronic otitis media without cholesteatoma by analysis of the intraoperative findings of the facial canal dehiscence. We retrospectively reviewed operative findings of 152 patients who underwent tympanoplasty with mastoidectomy for chronic otitis media. We examined every segment of the facial canal from the geniculate ganglion to the mastoid segment. Facial canal dehiscence was confirmed by palpation with a Rosen pick after inspection with a surgical microscope. The rate of facial canal dehiscence was 8.6% (13 of 152 cases), and the tympanic segment was the most commonly found region at 84.6% (11 of 13 cases). Of the 11 cases of tympanic segment dehiscence, 9 cases were involved the lateral aspect of the facial canal in the oval window area. There was one case each of facial canal dehiscence in the geniculate ganglion and the mastoid segment, respectively. The rate of facial canal dehiscence of 8.6% is not a low incidence rate, so even though performing a routine chronic ear operation, surgeons may encounter facial canal dehiscence at any time and should be prepared for the emergence of such a situation.
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                Author and article information

                Journal
                Int Arch Otorhinolaryngol
                Int Arch Otorhinolaryngol
                10.1055/s-00025477
                International Archives of Otorhinolaryngology
                Thieme Revinter Publicações Ltda (Rio de Janeiro, Brazil )
                1809-9777
                1809-4864
                July 2017
                14 September 2016
                : 21
                : 3
                : 239-242
                Affiliations
                [1 ]Department of Otorhinolaryngology, Başkale State Hospital, Van, Turkey
                [2 ]Department of Otorhinolaryngology, Tepecik Training and Research Hospital, Izmir, Turkey
                Author notes
                Address for correspondence Suphi Bulğurcu, MD Department of Otorhinolaryngology, Başkale State Hospital Başkale, Van, Van 65600Turkey suphibulg@ 123456yahoo.com
                Article
                0501or
                10.1055/s-0036-1592417
                5495596
                28680491
                a629787b-eeb1-4312-8da2-f1d709da8fa7
                © Thieme Medical Publishers
                History
                : 19 June 2016
                : 14 August 2016
                Categories
                Original Research

                ear ossicles,facial nerve,otitis
                ear ossicles, facial nerve, otitis

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