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Inicio Acta Otorrinolaringológica Española Clues for facial canal dehiscence in chronic otitis media
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Vol. 73. Issue 6.
Pages 339-345 (November - December 2022)
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Vol. 73. Issue 6.
Pages 339-345 (November - December 2022)
ARTÍCULO ORIGINAL
Clues for facial canal dehiscence in chronic otitis media
Pistas para dehiscencia del canal facial en la otitis media crónica
Afonso Castro
Corresponding author
afonsodomingoscastro@gmail.com

Autor para correspondencia.
, Francisco Sousa, Joana Costa, João Lino, José Abrunhosa, Cecília Almeida e Sousa
Centro Hospitalar Universitário do Porto, Porto, Portugal
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Abstract
Introduction and objectives

The goal of this study was to determine the impact of external and middle ear findings in the incidence of facial canal dehiscence (FCD) during mastoidectomy for chronic otitis media.

Material and methods

We examined the operative details of 186 patients who underwent primary tympanomastoidectomy for chronic otitis media between January 2015 and January 2020 retrospectively.

In this study we only evaluated the second portion of the facial nerve canal.

Results

The global prevalence of FCD was 22.6% (42/186 patients) with a higher incidence, of 38.7% (36/93), in patients with chronic otitis media with cholesteatoma (C-COM).

Associations were found between facial canal dehiscence, labyrinthine fistula (p˂ .001) and facial nerve paralysis (p˂ .001).

Ossicular erosions were observed at a significant level in patients with facial canal dehiscence, the incidence of FCD was significantly higher (p=.005, Odds ratio 5.489) when malleus and incus were eroded, incus plus stapes were eroded (p=.014; OR 4.059) and malleus, incus, and stapes together were eroded (p=.002; OR 4.929).

Conclusions

This study revealed an incidence of facial canal dehiscence of 22.6%. It also revealed that the presence of lateral semicircular canal fistula is associated with a higher prevalence of facial canal dehiscence.

The same was noted in the case of some ossicular erosions, especially the combinations of eroded malleus and incus, incus and stapes, and all 3 ossicles.

These findings raise awareness about the usefulness of middle ear findings in predicting FCD, thus providing valuable information for the otological surgeon to avoid iatrogenic injuries.

Keywords:
Facial canal dehiscence
Lateral semicircular canal fistula
Ossicle erosion
Chronic otitis media
Cholesteatoma
Resumen
Introducción y objetivos

El objetivo de este estudio fue determinar el impacto de los hallazgos del oído externo y medio en la incidencia de dehiscencia del canal facial (DCF) durante la mastoidectomía por otitis media crónica.

Material y métodos

Examinamos los detalles quirúrgicos de 186 pacientes intervenidos de timpanomastoidectomía primaria por otitis media crónica entre enero de 2015 y enero de 2020 de forma retrospectiva.

En este estudio solo evaluamos la segunda porción del canal del nervio facial.

Resultados

La prevalencia global de DCF fue del 22,6% (42/186 pacientes) con una incidencia mayor, del 38,7% (36/93), en pacientes con otitis media crónica con colesteatoma (C-COM).

Se encontraron asociaciones entre DCF, fístula laberíntica (p ˂ 0,001) y parálisis del nervio facial (p ˂ 0,001).

Se observaron erosiones osiculares significativas en pacientes con DCF. La incidencia de DCF fue significativamente mayor (p=0,005; odds ratio 5.489) cuando el martillo y el yunque estaban erosionados, el yunque y el estribo erosionados (p=0,014; OR 4,059) y erosiones del martillo, yunque y estribo juntos (p=0,002; OR 4,929).

Conclusiones

Este estudio reveló una incidencia de DCF del 22,6%. También reveló que la presencia de fístula del canal semicircular lateral se asocia con una mayor prevalencia de DCF.

Lo mismo se observó en el caso de algunas erosiones osiculares, especialmente las combinaciones de martillo y yunque, yunque y estribo, y los 3 huesecillos erosionados.

Estos hallazgos aumentan la conciencia sobre la utilidad de los hallazgos del oído medio que predicen la DCF y proporcionan información valiosa para el cirujano otológico sobre su esfuerzo por evitar lesiones yatrogénicas.

Palabras clave:
Dehiscencia del canal facial
Fístula del canal semicircular lateral
Erosión de los huesecillos
Otitis media crónica
Colesteatoma

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