-
The Medical Journal of Malaysia May 2022Electrode placement plays an important role in Brain Evoked Response Audiometry (BERA) recording. It is important to measure wave latency and amplitude accurately in...
BACKGROUND
Electrode placement plays an important role in Brain Evoked Response Audiometry (BERA) recording. It is important to measure wave latency and amplitude accurately in determining hearing level. Young children usually have limited mastoid area, and in certain condition, it is often difficult to place the vibrator and electrodes coinciding on the mastoid. Therefore, earlobe electrode is considered as an alternative placement.
PURPOSE
The aim was to correlate the wave V latency and amplitude on the mastoid and earlobe electrodes in BERA recording.
MATERIALS AND METHODS
Our study was a cross-sectional study conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between November 2020 and November 2021. Our subjects were infants and young children with normal hearing who underwent BERA examination. Electrodes were used to record BERA, and the electrodes were placed over the earlobes and mastoid area. Clicks at 20, 40, and 60 dB and tone burst at 500 Hz were used as stimuli for both ears.
RESULT
Fifty subjects (100 ears) were included in the study. Our statistical analysis showed that there was a strong correlation between wave V latencies from mastoid and earlobe electrode. Moderate correlation was also found in wave V amplitude between both electrodes.
CONCLUSION
Our study has demonstrated that placing electrodes on the earlobe area is reliable, particularly in certain condition when placing the electrodes on the mastoid area is not possible.
Topics: Audiometry, Evoked Response; Brain; Child; Child, Preschool; Cross-Sectional Studies; Electrodes; Hearing; Humans; Infant; Mastoid
PubMed: 35638488
DOI: No ID Found -
Otolaryngologia Polska = the Polish... Jul 2023<b>Introduction:</b> The facial nerve (FN) follows a complex route in the temporal bone. Successful temporal bone surgery requires knowledge of its course...
<b>Introduction:</b> The facial nerve (FN) follows a complex route in the temporal bone. Successful temporal bone surgery requires knowledge of its course which can be achieved using imaging methods such as computed tomography. This investigation aims to analyze the FN course in its mastoid portion and second genu and the frequency of its atypical course.</br></br> <b>Material and methods:</b> This is a retrospective study that enrolled 104 CT scans of temporal bones of patients followed up in the outpatient clinic of the Otorhinolaryngology Department of Dentistry Faculty of the Medical University of Warsaw between 2020 and 2022. FN courses were classified as straight, bulging, or letter "S"-like. Other parameters estimated: </br> • position of the second genu according to the prominence of the lateral semicircular canal (classified as lateral, medial, or middle) and its distance from a line adjacent to the lateral semicircular canal was measured;</br> • the distance between the short process of the incus and the outermost point of the second genu;</br> • the course of the mastoid portion of FN and the location of SG in comparison to the tympanic portion of n. VII. The course was later classified as lateral, medial, or middle.</br></br> <b>Results:</b> Among the 104 assessed temporal bones, the course of the mastoid portion of FN was classified as bulging in 47 cases (45.2%). Straight and letter "S"-like courses were present in 41 (39.4%) and 16 (15.4%) cases, respectively. Deviation of the second genu according to the prominence of the lateral semicircular canal was medial in 86 cases (82.7%), and middle in 4 cases (3.8%). In the rest, second genu was paramedian to the prominence of the later circular canal. The mean distance between the short process of the incus and the outermost point of SG was 4.9 mm (0.73 mm). The mastoid portion was located laterally, medially, and in the middle of the tympanic portion plane in, respectively, 4.8%, 83.7%, and 11.5%. The second genu was located laterally, medially, and in the middle of the tympanic portion plane in 1.9%, 73.1%, and 25%, respectively. In conclusion, seven temporal bones (6.7%) of five patients presented with a lateral displacement of FN in relation to the established anatomical landmarks.</br></br> <b>Conclusions:</b> Although the atypical course of FN, including the lateral displacement of the mastoid portion, is rare, screening for it is crucial before surgical exploration.
Topics: Humans; Mastoid; Facial Nerve; Retrospective Studies; Temporal Bone; Tomography, X-Ray Computed
PubMed: 37772376
DOI: 10.5604/01.3001.0016.3300 -
Anatomical Record (Hoboken, N.J. : 2007) Sep 2019Incus angles of axes (the angle between "short process axis" and the "long process axis") are more open in humans than chimpanzees: 64.0 versus 55.7 degrees (Quam et...
Incus angles of axes (the angle between "short process axis" and the "long process axis") are more open in humans than chimpanzees: 64.0 versus 55.7 degrees (Quam et al.: J Anat 225 (2014) 167-196). However, Flohr et al. (Anat Rec 293 (2010) 2094-2106) raise concern about interobserver agreement of the axes. The concern is important as phylogenetic relationships of mammals are inferred from the incus (and malleus and stapes). We sought to check (1) interobserver agreement; and (2) if the angles of the axes of incudes (incuses) exhibit bilateral symmetry, which is expected if the axes are genetically determined. We studied incudes from 41 modern adult crania with clinically normal temporal bones. Angles of axes were determined on rectilinear digital photographs of incudes in standard lateral orientation. Two observers independently drew the axes and measured the axes. Interobserver agreement was within 4 degrees for 24 of 34 left-sided incudes and for 27 of 35 right-sided incudes. The mean of the two observers' angle determinations were used. Left incudes' median was 67 degrees, range 60-73; right 67.5 degrees, range 58-77. Bilateral symmetry of angles of axes was found: r = 0.55, N = 31, 95% CI 0.24-0.75. Angles of axes of modern human incudes are probably genetically determined features, but are of doubtful physiologic or evolutionary advantage in modern humans. Interobserver agreement of angles of modern human axes is concerning and must be specified in reports. Consideration should be given to a convention to designate axes in ambiguous cases. Anat Rec, 302:1615-1619, 2019. © 2019 American Association for Anatomy.
Topics: Adult; Humans; Incus; Mastoid; Observer Variation; Temporal Bone
PubMed: 31120197
DOI: 10.1002/ar.24178 -
Homo : Internationale Zeitschrift Fur... Jun 20213D analysis of skeletal volumes has become an important field in digital anthropology studies. The volume of the mastoid process has been proposed to display significant...
3D analysis of skeletal volumes has become an important field in digital anthropology studies. The volume of the mastoid process has been proposed to display significant sexual dimorphism, but it has a complex shape and to date no study has quantified the full mastoid volume for sex estimation purposes. In this study we compared three different ways to isolate the volume of the mastoid process from digital 3D models of dry crania, and then evaluated the performance of the three different volume definitions for sex estimation purposes. A total of 170 crania (86 male, 84 females) excavated from five medieval Croatian sites were CT-scanned and used to produce 3D stereolitographic models. The three different isolation techniques were based on various anatomical landmarks and planes, as well as the anatomy of the mastoid process itself. Measurements of the three different mastoid volumes yielded different accuracies and precisions. Interestingly, anatomical structures were sometimes more useful than classical landmarks as demarcators of mastoid volume. For all three volume definitions, male mastoid volumes were significantly larger than female volumes, in both relative and absolute numbers. Sex estimation based on mastoid volume showed a slightly higher precision and better accuracy (71% correct classifications) than visual scoring techniques (67%) and linear distance measurements (69%) of the mastoid process. Sex estimation based on cranial size performed even better (78%), and multifactorial analysis (cranium size + mastoid volume) reached up to 81% accuracy. These results show that measurements of the mastoid volume represent a promising metric to be used in multifactorial approaches for sex estimation of human remains.
Topics: Croatia; Female; Forensic Anthropology; Humans; Male; Mastoid; Sex Characteristics; Sex Determination by Skeleton; Skull
PubMed: 33846705
DOI: 10.1127/homo/2021/1243 -
Danish Medical Journal Aug 2016Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR... (Review)
Review
Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate assessment following each procedure. Standard setting by establishing a proficiency level that can be used for mastery learning with deliberate practice could also further sophisticate directed, self-regulated learning in VR simulation-based training. VR simulation-based training should be embedded in a systematic and competency-based training curriculum for high-quality surgical skills training, ultimately leading to improved safety and patient care.
Topics: Clinical Competence; Education, Medical, Graduate; Humans; Learning Curve; Mastoid; Otolaryngology; Self-Assessment; Simulation Training
PubMed: 27477803
DOI: No ID Found -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jan 2020The clinical symptoms, imaging features and surgical treatment of congenital cholesteatoma are reported. The clinical data of 20 patients with congenital cholesteatoma...
The clinical symptoms, imaging features and surgical treatment of congenital cholesteatoma are reported. The clinical data of 20 patients with congenital cholesteatoma diagnosed and treated in our hospital from January 2016 to May 2018 were retrospectively analyzed, including the age of onset, clinical symptoms, signs, audiology, HRCT of temporal bone, surgical methods and so on. In 20 patients with congenital cholesteatoma, the clinical manifestations were hearing loss in the affected ears, including 5 cases with ear fullness and 4 cases with tinnitus. There were 13 cases of local yellow-white shadow of tympanic membrane, 5 cases of normal tympanic membrane and 2 cases of tympanic membrane bombe. Pure tone audiometry showed conductive deafness in 14 cases and mixed deafness in 6 cases. CT scan of temporal bone showed that 15 cases had pneumatic type of mastoid, 4 cases had diploectic type and 1 case had sclerostic type. There were 15 cases of interspersed flocculent shadow and 5 cases of mass shadow. Among the 20 cases of chronic otitis media with cholesteatoma, 6 have cholesteatoma in epitympanum, 4 in tympanic cavity, 3 in tympanic cavity and epitympanum, 2 in mastoid and tympanic antrum, 1 in mastoid, tympanic antrum and tympanic cavity, 1 in tympanic antrum, tympanic cavity and petrous apex, 1 in tympanic cavity, hypotympanum, posterior tympanum and ostium tympanicum tubae auditivae, 1 in aditus ad antrum, epitympanum and posterior tympanum, 1 in tympanic cavity, epitympanum and posterior tympanum. Intact canal wall mastoidectomy and tympanoplasty were performed in 7 cases, open mastoidectomy and tympanoplasty in 5 cases, middle ear exploration and tympanoplasty in 4 cases, atticotomy with reconstruction and tympanoplasty in 3 cases and subtotal temporal bone resection in 1 case. For patients with intact tympanic membrane presenting with hearing loss, the tympanic membranes should be carefully examined, and thin-section CT and MRI of temporal bone should be performed in time to avoid missed diagnosis of congenital cholesteatoma. Once diagnosed, surgery should be performed as soon as possible.
Topics: Cholesteatoma; Humans; Mastoid; Missed Diagnosis; Retrospective Studies; Treatment Outcome; Tympanic Membrane; Tympanoplasty
PubMed: 32086897
DOI: 10.13201/j.issn.1001-1781.2020.01.011 -
Head & Face Medicine Mar 2014Advanced parotid cancers more than 4 cm are firmly fixed around the main trunk of the facial nerve that can be hardly detected in narrow working space between mastoid...
BACKGROUND
Advanced parotid cancers more than 4 cm are firmly fixed around the main trunk of the facial nerve that can be hardly detected in narrow working space between mastoid process and parotid cancer. Even though facial nerve was preserved, facial nerve stretching during surgery has significantly serious effect on postoperative facial palsy.
OBJECTIVE
To evaluate usefulness of removing mastoid process in managing advanced parotid cancers to contribute identifying and preserving facial nerve.
METHOD
The study was performed on 18 advanced parotid cancers which was more than 4 cm and invaded around the facial nerve. Thirteen cases were fresh cases and 5 were recurrent cases.According to a modified Blair incision, the sternocleidomastoid muscle is detached from the mastoid process with electrocautery. When the mastoid process is removed, the main trunk of the facial nerve can be observed from stylomastoid foramen.This procedure was evaluated based on the duration of surgery, working space, and postoperative facial nerve function.
RESULTS
In eleven cases, facial nerves were sacrificed. Negative margins were achieved in 100% of the patients. The mean duration for removing of the mastoid process to identify facial nerves was 4.6 minutes. The mean size of the removed mastoid process was 2.1 cm in height and 2.3 cm in width, and 1.8 cm in depth. The extended mean working space was 16.0 cm3, and, as a result, the tumors could be resected without retraction.
CONCLUSION
Removing the mastoid process for advanced parotid tumors facilitates identification of the facial nerve and better preservation of the facial nerve function.
Topics: Adult; Aged; Aged, 80 and over; Facial Nerve; Female; Humans; Male; Mastoid; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Parotid Neoplasms; Plastic Surgery Procedures; Temporal Bone
PubMed: 24588993
DOI: 10.1186/1746-160X-10-6 -
Surgical and Radiologic Anatomy : SRA Jun 2019Körner's septum (KS) is a developmental remnant formed at the junction of mastoid and temporal squama, representing the persistence of the petrosquamosal suture. During...
PURPOSE OF THE STUDY
Körner's septum (KS) is a developmental remnant formed at the junction of mastoid and temporal squama, representing the persistence of the petrosquamosal suture. During mastoid surgery, it could be taken as a false medial wall of the antrum so that the deeper cells might not be explored. The aim of the study was to assess a Körner's septum prevalence and to analyze its topography.
METHODS
The study was performed on 80 sets of cone-beam computed tomography (CBCT) images of temporal bone (41 male, 39 female, 160 temporal bones). Körner's septum was identified and its thickness was measured on axial sections at three points: at the level of superior semicircular canal (SCC), at the level of head of malleus (HM) and at the level of tympanic sinus (TS).
RESULTS
KS was encountered at least in one point of measurements in 50 out of 80 sets of CBCT images (62.5%). The average thickness at the level of SCC was 0.87 ± 0.34 mm, at the level of HM was 0.99 ± 0.37 mm and at the level of TS was 0.52 ± 0.17 mm.
CONCLUSIONS
Körner's septum is a common structure in the temporal bone-air cell complex. It is more often encountered in men. In half of the patients, it occurs bilaterally. However, in most of the cases it is incomplete with anterior and superior portions being the most constant.
Topics: Adolescent; Adult; Aged; Anatomic Variation; Child; Cone-Beam Computed Tomography; Female; Humans; Male; Mastoid; Middle Aged; Petrous Bone; Young Adult
PubMed: 30539206
DOI: 10.1007/s00276-018-2149-3 -
PloS One 2022The interest in the mastoid air cell system arose from the association between temporal bone aeration and otitis media. Its size and growth have been considered when... (Review)
Review
The interest in the mastoid air cell system arose from the association between temporal bone aeration and otitis media. Its size and growth have been considered when planning chronic and middle ear surgeries. The objective of this review was to explore the literature on the size of mastoid air cells with age, highlighting various growth rates reported and mapping out areas yet to be fully understood for further research. A three-step systematic search was conducted for available literature on the subject matter viz; Google Scholar, Medline, Cochrane Library, and PubMed. Eligibility criteria guided the study selection, and eligible studies were subjected to appraisal using screening and quantitative criteria of mixed-method appraisal tool. A data extraction form was developed to extract information from eligible studies. Nine studies met the eligibility criteria. 55.6% of the included studies were conducted among the east and south Asian population, 33.3% were conducted among Scandinavians, and 11.1% in South America. Age groupings varied among studies; 33.3% utilized 1-year age grouping, 33.3% utilized 5-year age grouping, 11.1% utilized 10-year age grouping. In reporting the size of mastoid air cells across age groupings, 66.7% utilized area, 22.2% utilized volume, while 11.1% utilized both area and volume. Findings from this review showed that the mastoid air cells' size with respect to age differs among populations of different origins. The most common measurements were the area of air cells. The highest growth rate was reported up to 30 years. Findings also show the influence of sex on the size of mastoid air cells and growth rate with age, as females were reported to have larger air cells with rapid growth until puberty. However, the male mastoid air cell system continues a steady growth after puberty and becomes larger. Information still lacks in the volume of air cells in pediatric pneumatization.
Topics: Child; Female; Humans; Male; Mastoid; Otitis Media; South America; Temporal Bone
PubMed: 35657972
DOI: 10.1371/journal.pone.0269360 -
Acta Otorrinolaringologica Espanola 2015
Topics: Adult; Chronic Disease; Dermoid Cyst; Diagnosis, Differential; Ear Neoplasms; Eustachian Tube; Humans; Magnetic Resonance Imaging; Male; Mastoid; Otitis; Teratoma; Tomography, X-Ray Computed
PubMed: 24529876
DOI: 10.1016/j.otorri.2013.11.001