CT imaging analysis of anatomical factors related to revision mastoidectomy
Lei Li1, Yang Bentao2, Yan Zhongyu2, Li Yongxin1, Zhao Shouqin1, Zheng Jun1, Han Demin1
1Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 2Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Abstract：Objective To explore the anatomical factors related to the failure of mastoidectomy and to clarify the causes of recurrence of the disease after operation, so as to take targeted measures to improve the success rate of revision mastoidectomy.Methods From May 2008 to April 2016, the CT data of high resolution temporal bone in axial, coronal and oblique sagittal images of 120 patients undergoing the canal Wall down mastoidectomy in Beijing Tongren Hospital were retrospectively analyzed.The HRCT observations were compared with the lesions seen during reoperation.Results HRCT of temporal bone could clearly show the gross anatomic changes of mastoid cavity after the canal Wall down mastoidectomy. The main HRCT signs were enlargement of mastoid cavity, fusion with tympanic antrum and external auditory meatus, and abnormal soft tissue density of mass in the operative cavity. The HRCT images of axial, coronal and oblique sagittal positions in 120 patients showed that the high facial nerve ridge accounted for 39.2%(47/120). The residual cells in sinodural angle, mastoid apex, and around the labyrinth were 58.3%(70/120), 50.0%(60/120) and 25.8%(31/120) respectively. Insufficient opening for anterior epitympanic recess accounted for 41.7%(50/120) and the deep position of the sinus tympani was 40.0%(48/120). The lesion in tympanic ostium of Eustachian tube accounted for 32.5%(39/120). During the second operation, the lesions observed in the temporal bone CT were found in the residual cells of mastoid, tympanic ostium of eustachian tube, tympanic sinus and facial nerve ridge.Conclusions HRCT scan of temporal bone in patients undergoing revision mastoidectomy can find the anatomical factors of undry ear after primary mastoidectomy, which can be used as a reliable basis for revision mastoidectomy.
雷雳, 杨本涛, 闫钟钰, 李永新, 赵守琴, 郑军, 韩德民. 修正性乳突根治术相关解剖因素的CT影像分析[J]. 中华解剖与临床杂志, 2019, 24(6): 521-524.
Lei Li, Yang Bentao, Yan Zhongyu, Li Yongxin, Zhao Shouqin, Zheng Jun, Han Demin. CT imaging analysis of anatomical factors related to revision mastoidectomy. Chinese Journal of Anatomy and Clinics, 2019, 24(6): 521-524.
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2019, Vol. 24 
