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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 2, pp 513–520 | Cite as

Temporal bone trauma effects on auditory anatomical structures in mastoid obliteration

  • Aranka Ilea
  • Anca Butnaru
  • Silviu Andrei Sfrângeu
  • Mihaela Hedeșiu
  • Cristian Mircea Dudescu
  • Bianca Adina BoșcaEmail author
  • Veronica Elena Trombitaș
  • Radu Septimiu Câmpian
  • Silviu Albu
Head & Neck
  • 55 Downloads

Abstract

Purpose

The risk of temporal bone fractures in head trauma is not negligible, as injuries also depend on the resistance and integrity of head structures. The capacity of mastoid cells to absorb part of the impact kinetic energy of the temporal bone is diminished after open cavity mastoidectomy, even if the surgical procedure is followed by mastoid obliteration. The aim of our study was to evaluate the severity of lesions in auditory anatomical structures after a lateral impact on cadaveric temporal bones in which open cavity mastoidectomy followed by mastoid obliteration was performed, compared to cadaveric temporal bones with preserved mastoids.

Methods

The study was carried out on 20 cadaveric temporal bones, which were randomly assigned to two groups. In the study group, open cavity mastoidectomy followed by mastoid obliteration with heterologous materials was performed. All temporal bones were impacted laterally under the same conditions. Temporal bone fractures were evaluated by CT scan.

Results

External auditory canal fractures were six times more seen in the study group. Tympanic bone fractures were present in 80% of the samples in the study group and 10% in the control group (p = .005). Middle ear fractures were found in 70% of the samples in the study group and 10% in the control group (p = .02). Otic capsule violating fractures of the temporal bone were present only in the study group.

Conclusions

Mastoid obliteration with heterologous materials after open cavity mastoidectomy increases the risk of fracture, with the involvement of auditory anatomical structures.

Keywords

Temporal bone fracture Mastoidectomy Mastoid obliteration Auditory anatomical structures Cadaveric study 

Notes

Acknowledgements

This study was funded by the “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, Internal Grant no. 4944/8/08.03.2016.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest with respect to the authorship and/or publication of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania, No. 250/22.02.2011) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The study was conducted on temporal bone harvested from human cadavers donated to the “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania.

References

  1. 1.
    Alves RD, Cabral Junior F, Fonseca AC, Bento RF (2016) Mastoid obliteration with autologous bone in mastoidectomy canal wall down surgery: a literature overview. Int Arch Otorhinolaryngol 20(1):76–83.  https://doi.org/10.1055/s-0035-1563382 CrossRefPubMedGoogle Scholar
  2. 2.
    Lenarz T (2018) Cochlear implant—state of the art. GMS Curr Top Otorhinolaryngol Head Neck Surg 16:Doc04.  https://doi.org/10.3205/cto000143 (eCollection 2017) PubMedPubMedCentralGoogle Scholar
  3. 3.
    Mosher HP (1911) A method of filling the excavated mastoid with a flap from the back of the auricle. Laryngoscope 21:1158–1162.  https://doi.org/10.1288/00005537-191112000-00007 Google Scholar
  4. 4.
    Mehta RP, Harris JP (2006) Mastoid obliteration. Otolaryngol Clin North Am 39:1129–1142.  https://doi.org/10.1016/j.otc.2006.08.007 CrossRefPubMedGoogle Scholar
  5. 5.
    Deshmukh S, Sharma A, Dabholkar J (2012) Mastoid cavity obliteration: our experience. Otolaryngol Pol 66(6):379–381.  https://doi.org/10.1016/j.otpol.2012.08.001 CrossRefPubMedGoogle Scholar
  6. 6.
    Ilea A, Butnaru A, Sfrângeu SA et al (2014) Role of mastoid pneumatization in temporal bone fractures. AJNR Am J Neuroradiol 35(7):1398–1404.  https://doi.org/10.3174/ajnr.A3887 CrossRefPubMedGoogle Scholar
  7. 7.
    Kang HM, Kim MG, Boo SH et al (2012) Comparison of the clinical relevance of traditional and new classification systems of temporal bone fractures. Eur Arch Otorhinolaryngol 269(8):1893–1899.  https://doi.org/10.1007/s00405-011-1849-7 CrossRefPubMedGoogle Scholar
  8. 8.
    Dahiya R, Keller JD, Litofsky NS, Bankey PE, Bonassar LJ, Megerian CA (1999) Temporal bone fractures: otic capsule sparing versus otic capsule violating clinical and radiographic considerations. J Trauma 47:1079–1083. https://www.ncbi.nlm.nih.gov/pubmed/10608536
  9. 9.
    Saraiya PV, Aygun N (2009) Temporal bone fractures. Emerg Radiol 16(4):255–265.  https://doi.org/10.1007/s10140-008-0777-3 CrossRefPubMedGoogle Scholar
  10. 10.
    Wood CP, Hunt CH, Bergen DC et al (2014) Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. AJNR Am J Neuroradiol 35(1):186–190.  https://doi.org/10.3174/ajnr.A3609 CrossRefPubMedGoogle Scholar
  11. 11.
    Little SC, Kesser BW (2006) Radiographic classification of temporal bone fractures: clinical predictability using a new system. Arch Otolaryngol Head Neck Surg 132(12):1300–1304.  https://doi.org/10.1001/archotol.132.12.1300 CrossRefPubMedGoogle Scholar
  12. 12.
    Lee HB, Lim HJ, Cho M et al (2013) Clinical significance of β-tricalcium phosphate and polyphosphate for mastoid cavity obliteration during middle ear surgery: human and animal study. Clin Exp Otorhinolaryngol 6(3):127–134.  https://doi.org/10.3342/ceo.2013.6.3.127 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Uzun C, Kutoglu T (2007) Assessment of visualization of structures in the middle ear via Tos modified canal wall-up mastoidectomy versus classic canal wall-up and canal wall-down mastoidectomies. Int J Pediatr Otorhinolaryngol 71(6):851–856.  https://doi.org/10.1016/j.ijporl.2007.02.004 CrossRefPubMedGoogle Scholar
  14. 14.
    Heo KW, Kang MK, Park JY (2014) Alternative to canal wall-down mastoidectomy for sclerotic mastoid cavities: epitympanoplasty with mastoid obliteration. Ann Otol Rhinol Laryngol 123(1):47–52.  https://doi.org/10.1177/0003489414521387 CrossRefPubMedGoogle Scholar
  15. 15.
    Irving RM, Gray RF, Moffat DA (1994) Bone pâté obliteration or revision mastoidectomy: a five-symptom comparative study. Clin Otolaryngol Allied Sei 19:158–160. https://www.ncbi.nlm.nih.gov/pubmed/8026096
  16. 16.
    East CA, Brough MD, Grant HR (1991) Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 105(6):417–420. https://www.ncbi.nlm.nih.gov/pubmed/?term=East+CA%2C+Brough+MD%2C+Grant+HR.+Mastoid+obliteration+with+the+temporoparietal+fascia+flap.+J+Laryngol+Otol+1991%3B105(6)%3A417-20
  17. 17.
    Montandon P, Benchaou M, Guyol JP (1995) Modified canal wall-up mastoidectomy with mastoid obliteration for severe chronic otitis media. ORL J Otorhinolaryngol Relat Spec 57(4):198–201.  https://doi.org/10.1159/000276739 CrossRefPubMedGoogle Scholar
  18. 18.
    Bagot d’Arc M, Daculsi G, Emam N (2004) Biphasic ceramics and fibrin sealant for bone reconstruction in ear surgery. Ann Otol Rhinol Laryngol 113(9):711–720.  https://doi.org/10.1177/000348940411300907 CrossRefPubMedGoogle Scholar
  19. 19.
    Kupperman D, Tange RA (2001) Ionomeric cement in the human middle ear cavity: long-term results of 23 cases. Laryngoscope 111(2):306–309.  https://doi.org/10.1097/00005537-200102000-00022 CrossRefPubMedGoogle Scholar
  20. 20.
    Clark MP, Bottrill I (2007) SerenoCem-glass ionomeric granules: a 3-year follow-up assessment of their effectiveness in mastoid obliteration. Clin Otolaryngol 32(4):287–290.  https://doi.org/10.1111/j.1365-2273.2007.01478.x CrossRefPubMedGoogle Scholar
  21. 21.
    Cho SW, Cho YB, Cho HH (2012)) Mastoid obliteration with silicone blocks after canal wall down mastoidectomy. Clin Exp Otorhinolaryngol 5(1):23–27.  https://doi.org/10.3342/ceo.2012.5.1.23 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Sarin J, Grénman R, Aitasalo K, Pulkkinen J (2012) Bioactive glass S53P4 in mastoid obliteration surgery for chronic otitis media and cerebrospinal fluid leakage. Ann Otol Rhinol Laryngol 121(9):563–569.  https://doi.org/10.1177/000348941212100901 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Oral Rehabilitation, Oral Health and Dental Office Management, Faculty of Dentistry“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-NapocaCluj-NapocaRomania
  2. 2.Department of Radiology, Faculty of Medicine“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-NapocaCluj-NapocaRomania
  3. 3.Department of Dental Radiology, Faculty of Dentistry“Iuliu Hațieganu” University of Medicine and PharmacyCluj-NapocaRomania
  4. 4.Department of Mechanical Engineering, Faculty of MechanicsTechnical University Cluj-NapocaCluj-NapocaRomania
  5. 5.Department of Histology, Faculty of Medicine“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-NapocaCluj-NapocaRomania
  6. 6.Department of Cervicofacial and ENT Surgery, Faculty of Dentistry“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-NapocaCluj-NapocaRomania
  7. 7.Department of Oral Rehabilitation, Oral Health and Dental Office Management, Faculty of Dentistry“Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-NapocaCluj-NapocaRomania

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