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Science Progress 2023This study aimed to determine mastoid emissary canal's (MEC) and mastoid foramen (MF) prevalence and morphometric characteristics on cone-beam computed tomography (CBCT)...
OBJECTIVES
This study aimed to determine mastoid emissary canal's (MEC) and mastoid foramen (MF) prevalence and morphometric characteristics on cone-beam computed tomography (CBCT) images to underline its clinical significance and discuss its surgical consequences.
METHODS
In the retrospective analysis, two oral and maxillofacial radiologists analyzed the CBCT images of 135 patients (270 sides). The biggest MF and MEC were measured in the images evaluated in MultiPlanar Reconstruction (MPR) views. The MF and MEC mean diameters were calculated. The mastoid foramina number was recorded. The prevalence of MF was studied according to gender and side of the patient.
RESULTS
The overall prevalence of MEC and MF was 119 (88.1%). The prevalence of MEC and MF is 55.5% in females and 44.5% in males. MEC and MF were identified as bilateral in 80 patients (67.20%) and unilateral in 39 patients (32.80%). The mean diameter of MF was 2.4 ± 0.9 mm. The mean height of MF was 2.3 ± 0.9. The mean diameter of the MEC was 2.1 ± 0.8, and the mean height of the MEC was 2.1 ± 0.8. There is a statistical difference between the genders (p = 0.043) in foramen diameter. Males had a significantly larger mean diameter of MF in comparison to females.
CONCLUSION
MEC and MF must be evaluated thoroughly if the surgery is contemplated. Radiologists and surgeons should be aware of mastoid emissary canal morphology, variations, clinical relevance, and surgical consequences while operating in the suboccipital and mastoid areas to avoid unexpected and catastrophic complications. CBCT may be a reliable imaging diagnostic technique.
Topics: Humans; Male; Female; Mastoid; Retrospective Studies; Cone-Beam Computed Tomography; Prevalence; Clinical Relevance
PubMed: 37262004
DOI: 10.1177/00368504231178382 -
Acta Otorrinolaringologica Espanola Feb 2003The osteomas of the mastoids are slow growing benign tumors, made predominantly of mature bone. Clinically these tumors are asymptomatic, except for cosmetic...
The osteomas of the mastoids are slow growing benign tumors, made predominantly of mature bone. Clinically these tumors are asymptomatic, except for cosmetic deformities, and they are usually casual radiological findings. Surgical treatment is indicated for symptomatic osteomas. In Spain only sixteen cases of extracanalicular osteoma have been described in the literature. Two new cases are reported and a review of the literature is presented.
Topics: Adult; Bone Neoplasms; Female; Humans; Male; Mastoid; Osteoma
PubMed: 12802983
DOI: 10.1016/s0001-6519(03)78389-7 -
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 -
Auris, Nasus, Larynx Feb 2017IgG4-related disease (IgG4-RD) is a chronic inflammatory disorder, characterized by elevated serum IgG4 levels as well as abundant infiltration of IgG4-positive... (Review)
Review
IgG4-related disease (IgG4-RD) is a chronic inflammatory disorder, characterized by elevated serum IgG4 levels as well as abundant infiltration of IgG4-positive plasmacytes and fibrosis in various organs, including the head and neck region. In particular, the salivary glands, orbit, and thyroid are common sites of disease involvement. IgG4-RD is diagnosed based on various clinical, serological, and histopathological findings, none of which are pathognomonic. Hence, various differential diagnoses, which exhibit elevated serum IgG4 levels and infiltration of IgG4-postive cells into tissues, need to be excluded, especially malignant diseases and mimicking disorders. Systemic corticosteroids are generally effective in inducing IgG4-RD remission; however, recurrent or refractory cases are common. In addition, although the pathogenic mechanisms of IgG4-RD remain unclear, an antigen-driven inflammatory condition is believed to be involved. Recent studies have indicated the important pathogenic role of B cell/T cell collaboration and innate immunity in this disease. Nevertheless, additional research and discussions are needed to resolve many remaining questions. In this review, we provide an overview of the recent insights on the history, clinical features, diagnosis, and treatment of IgG4-RD in the head and neck region. Furthermore, we have also addressed the pathogenesis of this disease.
Topics: Adrenal Cortex Hormones; Autoimmune Diseases; Autoimmune Hypophysitis; Dacryocystitis; Humans; Immunoglobulin G; Lymphadenitis; Mastoiditis; Neuritis; Otitis; Rhinitis; Sialadenitis; Sinusitis; Thyroiditis, Autoimmune
PubMed: 27956101
DOI: 10.1016/j.anl.2016.10.011 -
La Radiologia Medica Sep 2023Cholesteatoma is caused by disorders of the middle ear ventilation that trigger a progressive series of events responsible for its formation. The aim of this study was...
BACKGROUND
Cholesteatoma is caused by disorders of the middle ear ventilation that trigger a progressive series of events responsible for its formation. The aim of this study was to identify possible radiological CT-derived parameters predisposing to ventilation disorders and cholesteatoma.
METHODS
In this retrospective study, patients diagnosed with cholesteatomatous chronic otitis media who underwent temporal bone CT and open tympanoplasty surgery have been included, as well as control patients with clinical examination negative for organic otological pathology who underwent temporal bone CT for other reasons. For each patient, the following parameters have been extracted from CT volumes: degree of mastoid pneumatization, prominence of the cog, patency of the Eustachian tube, antrum width, aditus width, anterior and posterior epitympanic widths, and epitympanic height.
RESULTS
Sixty patients have been included, thirty of whom belonged to the group of patients with cholesteatoma and the remaining part to the group of patients without organic otological pathology. The prevalence of a low degree of mastoid pneumatization was significantly higher among patients with cholesteatoma, as well as for the prevalence of cog prominence (p < 0.001). All the continuous variables were found to have statistical significance (p < 0.05) in the comparison between groups except for the width of the antrum.
CONCLUSION
Mastoid pneumatization degree, prominence of the cog and epitympanic measures based on temporal bone CT could be good radiological correlates of the ventilatory capabilities of the epitympanum which, if compromised, can facilitate the development of cholesteatoma.
Topics: Humans; Cholesteatoma, Middle Ear; Retrospective Studies; Temporal Bone; Mastoid; Tomography, X-Ray Computed
PubMed: 37537372
DOI: 10.1007/s11547-023-01677-8 -
Acta Otorrinolaringologica Espanola Apr 2006To review our experience and results in the diagnosis and treatment of acute mastoiditis, a pathology with an increasing incidence in the recent years. (Review)
Review
OBJECTIVE
To review our experience and results in the diagnosis and treatment of acute mastoiditis, a pathology with an increasing incidence in the recent years.
METHODS
The study reviewed 49 pediatric patients diagnosed and treated of acute mastoiditis between 1994 and 2003 in our hospital. We summarize epidemiologic, laboratory and clinical features.
RESULTS
The mean age was 2.5 years. Seventy-five percent of cases were in autumn and winter months and nearly twenty-five percent had been diagnosed in the last year. S. pneumoniae was the most commonly isolated pathogen (28.6%), although a sterile result was the most frequent (38.1%). Twenty-four patients (48.9%) required surgical treatment. Only five patients (10.2%) developed complications.
CONCLUSIONS
Acute mastoiditis is a pathology with an important incidence and is generally the consequence of an untreated otitis or an insufficient treatment. Due to the low number of complications, we can not estimate through statistical analysis valid markers like predictors for complication.
Topics: Acute Disease; Age Distribution; Anti-Infective Agents; Child; Child, Preschool; Humans; Incidence; Mastoiditis; Recurrence; Retrospective Studies; Seasons
PubMed: 16686225
DOI: 10.1016/s0001-6519(06)78685-x -
Ear, Nose, & Throat Journal Jul 2018When cochlear implantation was first introduced, the mastoidectomy and posterior tympanotomy approach was the most frequently used technique to gain access to the middle...
When cochlear implantation was first introduced, the mastoidectomy and posterior tympanotomy approach was the most frequently used technique to gain access to the middle ear and the cochlea. Since 2000, several authors have routinely used a non-mastoidectomy nonposterior tympanotomy technique, which has undergone several modifications. Alternative surgical techniques for cochlear implantation have recently been introduced, such as endomeatal-alone or suprameatal-alone and combined posterior tympanotomy/endomeatal approaches. The goal of this study was to describe another modification of this less invasive technique to perform cochlear implantation. Cochlear implantations were performed between January 1, 2002, and December 31, 2012, in 220 patients through the posterior suprameatal approach. In reviewing our experiences, we have concluded that this approach, which eliminates the need for mastoidectomy, is considered safe, time-efficient, and minimally invasive. The possible pitfalls and the microsurgical relevance of anatomic structures of this technique are discussed in detail. Using this technique, not all classical anatomic orientation points are identified. However, certain landmarks predict the depth and the three-dimensional location of invisible anatomic structures.
Topics: Adolescent; Adult; Aged; Anatomic Landmarks; Child; Child, Preschool; Cochlea; Cochlear Implantation; Ear, Middle; Female; Humans; Infant; Male; Mastoid; Middle Aged; Treatment Outcome; Young Adult
PubMed: 30036438
DOI: 10.1177/014556131809700702 -
The Israel Medical Association Journal... Feb 2021Otogenic cerebral sinus vein thrombosis (CSVT) is a rare but severe complication of otitis media in children. To date, the role of prothrombotic evaluation is still...
BACKGROUND
Otogenic cerebral sinus vein thrombosis (CSVT) is a rare but severe complication of otitis media in children. To date, the role of prothrombotic evaluation is still controversial.
OBJECTIVES
To report the clinical manifestations, prothrombotic evaluation, and current management of CSVT.
METHODS
We performed a retrospective study of nine pediatric patients with otogenic CSVT who underwent prothrombotic evaluation between 2008 and 2018.
RESULTS
Prominent clinical features included persistent otorrhea (88.8%), signs of mastoiditis (88.8%), high fever ≥ 38.3°C (100%), a classic spiking fever pattern (55.5%), and neurological signs (55.5%). A subperiosteal abscess (66.6%) was the most common otitis media complication associated with mastoiditis and CSVT. No microorganism was identified in 55.5% of patients. Cultures collected from ear secretions had a low yield (6.25%). However, PCR assays had a high detection rate (100%; n=3). The prothrombotic evaluation demonstrated an abnormal LAC-dRVVT ratio (6/9), elevated Factor VIII (5/8) (and a combination of both in four patients), antiphospholipid antibodies (2/8), and high homocysteine levels (1/5).The surgical intervention of choice included one-sided mastoidectomy with myringotomy and ventilation-tube placement on the affected side (77.7%). There were no mortalities and no long-term sequela except chronic otitis media (22.2%).
CONCLUSIONS
Our findings demonstrate good outcomes for otogenic CSVT treatment with intravenous antibiotics, anticoagulation, and conservative surgical intervention, which supports the current trend in management. The prothrombotic evaluation revealed transient inflammation-related risk factors but did not alter management. Further prospective multicenter studies are needed to determine its relevance.
Topics: Anti-Bacterial Agents; Anticoagulants; Child, Preschool; Female; Humans; Infant; Male; Mastoiditis; Middle Ear Ventilation; Otitis Media; Retrospective Studies; Sinus Thrombosis, Intracranial; Thrombophilia
PubMed: 33595215
DOI: No ID Found -
Ear, Nose, & Throat Journal Jun 2023To evaluate the feasibility, morphological, and functional outcomes of endoscopic retrograde transcanal mastoidectomy.
OBJECTIVES
To evaluate the feasibility, morphological, and functional outcomes of endoscopic retrograde transcanal mastoidectomy.
STUDY DESIGN
Prospective study.
SETTINGS
Tertiary Referral Hospital.
MATERIALS AND METHODS
We analyzed 31 patients with a diagnosis of chronic otitis media with cholesteatoma that extended to the mastoid cavity who underwent endoscopic transcanal retrograde canal wall down mastoidectomy under general anesthesia. The tympanic membrane and posterior canal wall reconstruction were done using the tragal cartilage palisade technique reinforced with perichondrium. Morphological and functional results were reported in the follow-up of a minimum of 1 year. The graft uptake was also compared with the presence of granulations and discharge status.
RESULTS
Graft uptake and disease-free conditions were achieved in 21 of 24 patients, that is, 87.5%, and 3 patients required revision surgery. The graft uptake rate was not affected by the presence of granulation tissues and discharge. The hearing was improved after the surgery, which was statistically significant.
CONCLUSION
Endoscopic retrograde mastoidectomy is a new technique to deal with cholesteatoma with excellent results. It is more functional, ideal for sclerotic mastoid, allows faster wound healing, has excellent outcomes, and is a minimally invasive procedure that avoids postauricular incision and tissue dissection. Because the set up for the surgery costs less, it holds a promising future for the developing countries.
Topics: Humans; Mastoidectomy; Prospective Studies; Cholesteatoma, Middle Ear; Treatment Outcome; Retrospective Studies; Mastoid
PubMed: 33848200
DOI: 10.1177/01455613211009439 -
Turkish Neurosurgery Apr 2009Infratentorial subdural empyema is a life-threatening rare complication of bacterial meningitis. Infratentorial subdural empyemas constitute only a small portion of all...
Infratentorial subdural empyema is a life-threatening rare complication of bacterial meningitis. Infratentorial subdural empyemas constitute only a small portion of all cases with intracranial infectious diseases. We present a 15-year-old boy with infratentorial subdural empyema. Empyema was diagnosed with serial follow-up computed tomography and magnetic resonance imaging while he was being treated for bacterial meningitis secondary to neglected mastoiditis. The patient was successfully treated with emergent surgery and appropriate antibiotics. Empyema should be considered in patients with suspected or proven bacterial menengitis and associated ear nose throat infection with neurological signs that suggest a posterior fossa lesion.
Topics: Adolescent; Anti-Bacterial Agents; Combined Modality Therapy; Empyema, Subdural; Humans; Magnetic Resonance Imaging; Male; Mastoiditis; Meningitis, Bacterial; Tomography, X-Ray Computed
PubMed: 19431137
DOI: No ID Found