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Surgical importance of the tympanic bone: multidetector computed tomography findings

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Objectives: To measure tympanic bone thickness (anterior-superior, anterior-inferior, and inferior wall), external ear canal length, and tympanomandibular distance that can be useful in cases that undergo tympanic bone resection. Materials and Methods: The temporal computed tomography (CT) images of 349 patients were retrospectively evaluated. The anterior-inferior, anterior-superior, and inferior wall thicknesses; tympanomandibular distance; and external auditory canal (EAC) bone canal length were measured from the narrowest part of the canal. The shapes of the EAC in the coronal and sagittal planes were also examined. Results: The numbers of female and male patients were similar, and the mean age was 49.45±13.95 years. The anterior-superior, anterior-inferior, and inferior wall thicknesses were 1.92±0.60, 2.54±0.74, and 9.16±2.20 mm, respectively. The anterior-superior and anterior-inferior wall thicknesses and canal lengths were greater on the right side (P<0.001). All measurement values were higher in males, except right tympanomandibular distance (P<0.05). A non-significant negative correlation was found between the age of the participants and the left anterior-inferior wall and tympanomandibular distance on both sides. Intra-observer agreement was high for all measurements. We observed four main shapes in the external ear canal in the coronal plane: Type 3, Type 2, Type 1, and Type 4 in order of frequency on the right, and Type 2, Type 3, Type 1, and Type 4 on the left. In the sagittal plane, we detected three shapes: oval (74.4%), triangular (16.3%), and round (9.4%). Conclusion: The anterior wall thicknesses and tympanomandibular distance should be measured on preoperative temporal bone CT to safely perform tympanic bone anterior resection, which is required in some otological procedures, and also to prevent temporomandibular joint damage.

Abstract

Objectives: To measure tympanic bone thickness (anterior-superior, anterior-inferior, and inferior wall), external ear canal length, and tympanomandibular distance that can be useful in cases that undergo tympanic bone resection. Materials and Methods: The temporal computed tomography (CT) images of 349 patients were retrospectively evaluated. The anterior-inferior, anterior-superior, and inferior wall thicknesses; tympanomandibular distance; and external auditory canal (EAC) bone canal length were measured from the narrowest part of the canal. The shapes of the EAC in the coronal and sagittal planes were also examined. Results: The numbers of female and male patients were similar, and the mean age was 49.45±13.95 years. The anterior-superior, anterior-inferior, and inferior wall thicknesses were 1.92±0.60, 2.54±0.74, and 9.16±2.20 mm, respectively. The anterior-superior and anterior-inferior wall thicknesses and canal lengths were greater on the right side (P<0.001). All measurement values were higher in males, except right tympanomandibular distance (P<0.05). A non-significant negative correlation was found between the age of the participants and the left anterior-inferior wall and tympanomandibular distance on both sides. Intra-observer agreement was high for all measurements. We observed four main shapes in the external ear canal in the coronal plane: Type 3, Type 2, Type 1, and Type 4 in order of frequency on the right, and Type 2, Type 3, Type 1, and Type 4 on the left. In the sagittal plane, we detected three shapes: oval (74.4%), triangular (16.3%), and round (9.4%). Conclusion: The anterior wall thicknesses and tympanomandibular distance should be measured on preoperative temporal bone CT to safely perform tympanic bone anterior resection, which is required in some otological procedures, and also to prevent temporomandibular joint damage.

참고문헌 (10)

  1. Isaacson B, "Anatomy and surgical approach of the ear and temporal bone", Head Neck Pathol, 12, pp.321~327 (2018)[DOI]
  2. Lavy J, "Canalplasty : review of 100 cases", J Laryngol Otol, 115, pp.270~273 (2001)[DOI]
  3. Selesnick SH, "Herniation of the temporomandibular joint into the external auditory canal : a complication of otologic surgery", Am J Otol, 16, pp.751~757 (1995)
  4. Kim CW, "Osteomyelitis of the temporomandibular joint following canal wall down mastoidectomy", J Craniofac Surg, 26, pp.e351~e353 (2015)[DOI]
  5. Litton WB, "The relationship of the facial canal to the annular sulcus", Laryngoscope, 79, pp.1584~1604 (1969)
  6. Williams BJ, "The relationship of the facial nerve to the tympanic annulus and external auditory canal", J Otolaryngol Soc Aust, 6, pp.95~96 (1988)
  7. Adad B, "Relationship of the facial nerve to the tympanic annulus : a direct anatomic examination", Laryngoscope, 109, pp.1189~1192 (1999)[DOI]
  8. Rodrigues S, "A radiologic study of the tympanic bone : anatomy and surgery", Otol Neurotol, 24, pp.796~799 (2003)[DOI]
  9. Eckerdal O, "External bony auditory canal and the tympanic bone. Morphologic properties and influences on the tomographic reproduction", Acta Radiol Diagn(Stockh), 21, pp.425~431 (1980)[DOI]
  10. Mancini F, "Complications and their management in tympanomastoid surgery", Otolaryngol Clin North Am, 32, pp.567~583 (1999)[DOI]

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