Abstract
BackgroundHigh-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed middle ear anatomy particularly its hidden area. The purpose of the current study was to assess the sinus tympani (ST) and supratubal recess (STR) by HRCT, to create CT classification of the STR depth, and to study the relationship between ST types and the new STR grades.ResultsIn HRCT of non-pathological temporal bones of 100 subjects (200 ears), measurements of the STR and ST were calculated, registered, and analyzed. The depth of the STR was classified into grade 1 with depth less than 3 mm, grade 2 with depth ranged between 3 and 5 mm, and grade 3 with depth more than 5 mm. The mean STR length, width, and height were 4.17 ± 0.86, 3.55 ± 0.65, and 3.64 ± 0.7 mm, respectively, while the ST mean length and width of were 2.52 ± 0.5 and 1.82 ± 0.78 mm, respectively, without significant differences between either sexes or sided. The ST types were found to be type A in 56 ears (28%), type B in 142 ears (71%), and type C in 2 ears (1%). The STR grading was grade 1 in 12 ears (6%), grade 2 in 160 ears (80%), and grade 3 in 28 ears (14%) without significant relationship between ST types and STR grading (P = 0.3).ConclusionThe current study provided reliable and applicable methods of CT assessment of STR and ST that can help to predict the degree of surgical visibility of the ST and STR during ear surgery.
Highlights
High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed middle ear anatomy its hidden area
We retrospectively studied CT images of paranasal sinuses done for patients having symptoms of sinus-related complaints and who had no ear symptoms and no previous ear surgery
Two hundred ears of 100 subjects were included in the current study: 46 (46%) females and 54 (54%) males
Summary
High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed middle ear anatomy its hidden area. Endoscopy provided an important and sometimes unexpected detailed middle ear anatomy for the hidden recesses such as the sinus tympani (ST) and the supratubal recess (STR). Maximum exposure of the ST and STR in cholesteatoma surgery and complete removal of the disease is mandatory [10]. Endoscopic exploration of such hidden recesses (ST and STR) provides visualization and magnification that is almost impossible to achieve with microscopic traditional approaches without excess bone
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