Incidence of Facial Canal Dehiscent Noted Intraoperatively in Unsafe Chronic Suppurative Otitis Media: A Retrospective Study

Abstract

Background: Dehiscence of the facial canal is a matter of great concern for an otologist as one of the most dreaded complications of mastoid surgery is injury to the facial nerve study was carried to determine the intra operative presence of facial canal dehiscence in primary and revision cholesteatoma surgery in a tertiary care centre. And also, our second goal was to identify association between FCD and other intra-operative pathological findings such as labyrinthine fistula, Dural plate dehiscence, sinus plate dehiscence in a group of patients with cholesteatoma surgery. Methods: A retrospective study was carried out in the department of Otorhinolaryngology in a tertiary referral hospital, Gujarat among 302 patients. The study’s inclusion criterion was primary and revision CWU and CWD tympano-mastoidectomy in patients who suffered from (CSOM) with cholesteatoma and exclusion criterion was charts with inadequate documentation. In addition, tympanoplasty cases were excluded as the study evaluated both tympanic and mastoid segments of facial nerve canal. Pre-operative clinical data and intra-operative findings were documented in a formatted questionnaire. Results: It was found that the incidence of FCD in our study of unsafe CSOM surgery was 21.22%. Conclusions: The surgeon should keep in mind during the procedures performed in the middle ear could potentially traumatize or damage the facial nerve at the site of dehiscence. A longer duration and more extensive cholesteatoma increase the chance of finding a dehiscent facial nerve. To this, we can prevent facial nerve paralysis and other complications in post-operative period and reduce the rate of morbidity.