Mastoid Segment Of Facial Nerve Research Articles

Radiological Parameters Predicting the Round Window Niche Visibility through Facial Recess Approach in Cochlear Implantation.

The aim was to study the radiological parameters using High Resolution Computed Tomography (HRCT) temporal bone to predict the Round Window Niche (RWN) visibility through the facial recess approach and to study radiological types of the round window niche. Prospective study was done in the patients underwent CI surgery from 2019 to 2021. HRCT radiological parameters of the patients and their intraoperative visualisation from video recordings were compared to predict the most feasible parameters to predict good visualisation of RWN. Among 51 patients (34 males, 17 females) in 48 children round window membrane insertion was done and in three children cochleostomy was done and in two children partial canal wall drilling was done due to poor visualisation of RWN area. Multiple parameters to assess the visibility of the RWN were used. Facial recess width (4.2mm), location of the mastoid segment of facial nerve (2mm), external auditory canal to basal turn of cochlea angle (< 13.50) and the radiological types (tunnel shape and semi-circular shape) of the RWN by HRCT were found to be significant parameters in predicting a good visualisation of the RWN. HRCT parameters prepare the surgeon to face the possibility of a difficult surgery and plan to deal with difficult situations. This would eventually lead to better preparedness of surgeons for management of complications.

Transmastoid/Infralabyrinthine Approach to the Jugular Foramen: 2-Dimensional Operative Video.

This approach is intended for tumors centered in the jugular foramen with extensions between intracranial and extracranial spaces, possible spread to the middle ear, and variable bony destruction. 1,2. Jugular foramen paragangliomas are complex lesions that usually invade and fill related venous structures. They present complex relationships with skull base neurovascular structures as internal carotid artery, lower cranial nerves (CNs), middle ear, and mastoid segment of facial nerve. In this way, it is essential to perform an adequate preoperative vascular study to evaluate sinus patency and the tumor blood supply, besides a computed tomography scan to depict bone erosion. Mastoidectomy through an infralabyrinthine route up to open the lateral border of jugular foramen, allowing exposure from the sigmoid sinus to internal jugular vein. Skeletonization of facial canal without exposure of facial nerve is performed and opening of facial recess to give access to the middle ear in way of a fallopian bridge technique. 2-10. If there is preoperative preservation of lower CN function, it is important to not remove the anteromedial wall of the internal jugular vein and jugular bulb. In addition, facial nerve should be exposed just in case of preoperative facial palsy to decompress or reconstruct the nerve. Variations are related mainly with temporal bone drilling depending on the extensions of the lesion, its source of blood supply, and preoperative preservation of CN function.Informed consent was obtained from the patient for the procedure and publication of his image.Anatomy images were used with permission from:• Ceccato GHW, Candido DNC, and Borba LAB. Infratemporal fossa approach to the jugular foramen. In: Borba LAB and de Oliveira JG. Microsurgical and Endoscopic Approaches to the Skull Base. Thieme Medical Publishers. 2021.• Ceccato GHW, Candido DNC, de Oliveira JG, and Borba LAB. Microsurgical Anatomy of the Jugular Foramen. In: Borba LAB and de Oliveira JG. Microsurgical and Endoscopic Approaches to the Skull Base. Thieme Medical Publishers. 2021.

Anterolateral (juxtacondylar) approach with limited mastoidectomy to resect a jugular foramen meningioma.

The anterolateral (juxtacondylar) approach with limited mastoidectomy is a suitable option to expose the postero-inferior part of the jugular foramen (JF). It is particularly indicated for tumors extending in the neck beyond the jugular foramen, especially in those cases necessitating both neck control as well as control of the mastoid segment of facial nerve. We describe here the steps to safely perform an anterolateral approach with mastoidectomy along with a brief description of its indications and limits. This approach represents a valid option to reach the JF. Its knowledge can improve the process of optimal approach selection when dealing with complex pathology involving the JF.

A Case of Cochlear Implantation in a Child with Congenital Aural Atresia and Cochlear and Cochlear Nerve Malformation

Congenital aural atresia (CAA) is usually accompanied by an anomalous course of facial nerves, which may run over the round window niche toward the promontory in some cases of CAA. Very rarely, cochlear malformation might coexist at the same ear which has CAA, in which case cochlear implantation can be difficult due to anomalous facial nerve. Herein we present a case of cochlear implantation performed in a child who had CAA along with cochlear hypoplasia and cochlear nerve aplasia. The mastoid segment of facial nerve was displaced anteriorly, running over the round window niche. The surgery was done successfully using the round window approach without facial nerve injury.

Congenital duplication of mastoid segment of facial nerve in child candidate for Cochlear Implantation Surgery: a rare case report.

Congenital duplication of mastoid segment of facial nerve in child candidate for Cochlear Implantation Surgery: a rare case report.

Congenital duplication of mastoid segment of facial nerve in child candidate for Cochlear Implantation Surgery: a rare case report

Congenital duplication of mastoid segment of facial nerve in child candidate for Cochlear Implantation Surgery: a rare case report

Transcanal Endoscopic Approach to the Mastoid Segment of Facial Nerve and the Role of the Pyramidal Eminence as a Landmark

Objectives: To study the feasibility of approaches in addressing the mastoid segment of facial nerve through transcanal route exclusively under endoscopic guidance and to verify the usefulness of the pyramidal eminence as a landmark.&#x0D; Study design: The prospective experimental study&#x0D; Setting: “Transcanal endoscopic temporal bone dissection lab” situated in the Surgiscope hospital, Chittagong, Bangladesh.&#x0D; Materials: 4 (Four) cadaveric temporal bones.&#x0D; Interventions: Two pure transcanal endoscopic approaches were applied to excavate the mastoid segment of facial nerve. In anterior-medial approach, the dissection was progressed from medial to the lateral direction through the retrotympanum focusing the anterior-medial side of the mastoid segment of facial nerve. Whereas in anterior-lateral approach, the dissection was progressed from lateral to the medial direction through the posterior canal wall focusing the anterior-lateral side of the mastoid segment of facial nerve. In both approaches, the pyramidal eminence was considered as an anatomical landmark to navigate the dissection for the excavation of the mastoid segment of facial nerve.&#x0D; Main outcome measures: The efficacy of each approach in respect of the complete excavation of the mastoid segment of facial nerve and the worthiness of the pyramidal eminence as the landmark for navigating the dissection.&#x0D; Results: In both transcanal endoscopic approaches, the entire mastoid segment of facial nerve could be exposed successfully. But in anterior-medial approach, the chorda tympani nerve was needed to be sacrificed. The search of the mastoid segment of facial nerve with the guidance of the pyramidal eminence was observed as effective and safe.&#x0D; Conclusion: The entire mastoid segment of facial nerve could be successfully addressed through transcanal route under pure endoscopic guidance. The pyramidal eminence has appeared as an important landmark for such endeavor.&#x0D; Bangladesh J Otorhinolaryngol; October 2019; 25(2): 108-115

The image variations in mastoid segment of facial nerve and sinus tympani in congenital aural atresia by HRCT and 3D VR CT

ObjectiveTo find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images. MethodsHRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n=25, 21 males, 4 females, mean age 13.8 years, range 6–19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients. ResultsOn the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (P<0.05). There was a significant negative correlation between the sinus tympani area (a-ST) and the distance between the horizontal lines of FN and RW midpoint (h-RF) (P<0.05). The mean area of sinus tympani in atresia group is larger (P<0.05). The shapes of the sinus tympani were classified into three categories: the cup-shaped, the pear-shaped and the boot-shaped. Area measurement indicated that the boot-shaped sinus tympani was a special variation with a large area, which only appears in CAA group. There were a significant difference between the area of the boot-shaped group and the other two groups (P<0.05). The morphologic differences of ST and other middle ear structures can also be observed visually in 3D VR CT images. ConclusionHRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation.

Clinical characteristics of spontaneous cholesteatoma of the external auditory canal in children comparing with cholesteatoma in adults

The purpose of this study was to investigate the characteristics of external auditory canal cholesteatoma (EACC) in children through evaluation of the clinical and radiologic features as well as treatment outcomes. The clinical records were retrospectively reviewed for children under 15 years of age diagnosed with spontaneous EACC between March 2004 and December 2011. The clinical data of adults diagnosed with spontaneous EACC during the same period were evaluated to compare with EACC in children. Eight patients (3 males and 5 females) with pediatric EACC and 18 patients (7 males and 11 females, 20 ears) with adult EACC were included within the boundary of the study. The mean ages were 12.4 years (age range 9-15) for pediatric EACC and 49.8 years (age range 29-79) for adult EACC patients. Follow-up periods ranged from 8 to 86 months (mean 32.5 ± 8.62) in pediatric EACC and from 6 to 72 months (mean 22.2 ± 5.36) in adult EACC. Pediatric EACC, showed involvement most commonly in the posterior wall, while the inferior wall was most commonly involved in adult EACC. Pediatric EACC tended to show a more focal involvement and was not as extensive as adult EACC. Extension into the adjacent structures was similar in both groups, but bony destruction was more common in the adult group. Two children and eight adult patients were treated with surgery, but four adult cases needed more extensive surgical treatment because their disease was widely spread to included areas such as the mastoid segment of facial nerve and the temporomandibular joint. Six pediatric cases treated with conservative management showed no progression of disease on physical examination at the last visit, but two cases of adults progressed and required canaloplasty. Pediatric EACC shows less aggressive behavior compared to adult EACC. Adequate management may work better in pediatric than in adult EACC, even though the treatment modality is conservative management.

Congenital duplication of mastoid segment of facial nerve: A rare case report

Congenital duplication of facial nerve is a very rare anomaly commonly associated with inner and middle ear anomalies. There can be duplication of mastoid, tympanic, or labyrinthine segments. We describe duplication of mastoid segment of facial nerve in a young female who also showed middle ear anomalies and external auditory canal atresia.

Empiric determinations of pre-teens and teenage music habits. Optimized sound level limitations for portable music players and discotheques: Ising H.; Babisch W.; Hanel J.; Kruppa B.; Pilgramm M.HNO (1995) 43/4 (244–249)

To find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images.HRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n = 25, 21 males, 4 females, mean age 13.8 years, range 6–19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients.On the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (P < 0.05). There was a significant negative correlation between the sinus tympani area (a-ST) and the distance between the horizontal lines of FN and RW midpoint (h-RF) (P < 0.05). The mean area of sinus tympani in atresia group is larger (P < 0.05). The shapes of the sinus tympani were classified into three categories: the cup-shaped, the pear-shaped and the boot-shaped. Area measurement indicated that the boot-shaped sinus tympani was a special variation with a large area, which only appears in CAA group. There were a significant difference between the area of the boot-shaped group and the other two groups (P < 0.05). The morphologic differences of ST and other middle ear structures can also be observed visually in 3D VR CT images.HRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation.