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Incidence of Facial Nerve Canal Dehiscence in Primary and Revision Cholesteatoma Surgery

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Abstract

The aim of this retrospective study was to determine the incidence of facial canal dehiscence (FCD) in primary and revision cholesteatoma surgery in a tertiary referral center. Moreover, our second goal was to identify association between FCD and other intra-operative pathological findings in a group of patients with cholesteatoma surgery. Inclusion criteria were primary and revision canal wall up and canal wall down tympanomastoidectomy in patients who suffers from chronic otitis media (COM) with cholesteatoma. An exclusion criterion was charts with in adequate documentation. In addition tympanoplasty cases were excluded due to evaluate both tympanic and mastoid segments of facial nerve canal. Preoperative clinical data and intra-operative findings were documented in a formatted questionnaire. We found the incidence of FCD in COM surgery was 18%. There was no difference between the primary and revision surgeries regarding its incidence. In addition, there was association between some preoperative or intra-operative findings of COM, such as middle fossa dural dehiscence, external auditory canal polyp, facial nerve paralysis, labyrinthine fistula, and FCD. In conclusions we found that there was no difference between primary and revision surgeries regarding the incidence of FCD. Surgeons should consider effective measures to prevent intra-operative facial nerve trauma in COM surgeries.

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References

  1. Kangsanarak J, Fooanant S, Ruckphaopunt K, Navacharoen N, Teotrakul S (1993) Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J Laryngol Otol 107(11):999–1004

    Article  CAS  PubMed  Google Scholar 

  2. Lin YS, Lin LC, Lee FP, Lee KJ (2009) The prevalence of chronic otitis media and its complication rates in teenagers and adult patients. Otolaryngol Head Neck Surg 140(2):165–170. doi:10.1016/j.otohns.2008.10.020

    Article  PubMed  Google Scholar 

  3. Ozbek C, Tuna E, Ciftci O, Yazkan O, Ozdem C (2009) Incidence of fallopian canal dehiscence at surgery for chronic otitis media. Eur Arch Oto-Rhino-Laryngol 266(3):357–362. doi:10.1007/s00405-008-0748-z

    Article  Google Scholar 

  4. Bayazit YA, Ozer E, Kanlikama M (2002) Gross dehiscence of the bone covering the facial nerve in the light of otological surgery. J Laryngol Otol 116(10):800–803. doi:10.1258/00222150260293600

    Article  PubMed  Google Scholar 

  5. Jaswal A, Jana AK, Sikder B, Sadhukhan SK, Jana U, Nandi TK (2008) Fallopian canal dehiscence: can it be pridicted. Indian J Otolaryngol Head Neck Surg 60(1):11–15. doi:10.1007/s12070-008-0006-0

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vashishth A, Singh Nagar TR, Mandal S, Venkatachalam VP (2013) Extensive intratemporal cholesteatomas: presentation, complications and surgical outcomes. Eur Arch Oto-Rhino-Laryngol. doi:10.1007/s00405-013-2852-y

    Google Scholar 

  7. Kim CW, Rho YS, Ahn HY, Oh SJ (2008) Facial canal dehiscence in the initial operation for chronic otitis media without cholesteatoma. Auris Nasus Larynx 35(3):353–356. doi:10.1016/j.anl.2007.09.012

    Article  PubMed  Google Scholar 

  8. Moody MW, Lambert PR (2007) Incidence of dehiscence of the facial nerve in 416 cases of cholesteatoma. Otol Neurotol 28(3):400–404. doi:10.1097/01.mao.0000247824.90774.22

    Article  PubMed  Google Scholar 

  9. Di Martino E, Sellhaus B, Haensel J, Schlegel JG, Westhofen M, Prescher A (2005) Fallopian canal dehiscences: a survey of clinical and anatomical findings. Eur Arch Oto-Rhino-Laryngol Head Neck Surg 262(2):120–126. doi:10.1007/s00405-004-0867-0

    Article  Google Scholar 

  10. Lin JC, Ho KY, Kuo WR, Wang LF, Chai CY, Tsai SM (2004) Incidence of dehiscence of the facial nerve at surgery for middle ear cholesteatoma. Otolaryngol Head Neck Surg 131(4):452–456. doi:10.1016/j.otohns.2004.02.054

    Article  PubMed  Google Scholar 

  11. Selesnick SH, Lynn-Macrae AG (2001) The incidence of facial nerve dehiscence at surgery for cholesteatoma. Otol Neurotol 22(2):129–132

    Article  CAS  PubMed  Google Scholar 

  12. Quaranta N, Cassano M, Quaranta A (2007) Facial paralysis associated with cholesteatoma: a review of 13 cases. Otol Neurotol 28(3):405–407. doi:10.1097/01.mao.0000265189.29969.c4

    Article  PubMed  Google Scholar 

  13. Smith JA, Danner CJ (2006) Complications of chronic otitis media and cholesteatoma. Otolaryngol Clin North Am 39(6):1237–1255. doi:10.1016/j.otc.2006.09.001

    Article  PubMed  Google Scholar 

  14. Chu FW, Jackler RK (1988) Anterior epitympanic cholesteatoma with facial paralysis: a characteristic growth pattern. Laryngoscope 98(3):274–279. doi:10.1288/00005537-198803000-00007

    Article  CAS  PubMed  Google Scholar 

  15. Antoli-Candela F Jr, Stewart TJ (1974) The pathophysiology of otologic facial paralysis. Otolaryngol Clin North Am 7(2):309–330

    PubMed  Google Scholar 

  16. Yetiser S, Tosun F, Kazkayasi M (2002) Facial nerve paralysis due to chronic otitis media. Otol Neurotol 23(4):580–588

    Article  PubMed  Google Scholar 

  17. Nomiya S, Kariya S, Nomiya R, Morita N, Nishizaki K, Paparella MM, Cureoglu S (2013) Facial nerve canal dehiscence in chronic otitis media without cholesteatoma. Eur Arch Oto-Rhino-Laryngol. doi:10.1007/s00405-013-2431-2

    Google Scholar 

  18. Nomiya S, Cureoglu S, Kariya S, Morita N, Nomiya R, Nishizaki K, Paparella MM (2011) Histopathological incidence of facial canal dehiscence in otosclerosis. Eur Arch Oto-Rhino-Laryngol 268(9):1267–1271. doi:10.1007/s00405-011-1510-5

    Article  Google Scholar 

  19. Li D, Cao Y (1996) Facial canal dehiscence: a report of 1,465 stapes operations. Ann Otol Rhinol Laryngol 105(6):467–471

    Article  CAS  PubMed  Google Scholar 

  20. Manolidis S (2000) Complications associated with labyrinthine fistula in surgery for chronic otitis media. Otolaryngol Head Neck Surg 123(6):733–737. doi:10.1067/mhn.2000.111288

    Article  CAS  PubMed  Google Scholar 

  21. Gacek RR (1974) The surgical management of labyrinthine fistulae in chronic otitis media with cholesteatoma. Ann Otol Rhinol Laryngol 83(Suppl 10):11–19

    Google Scholar 

  22. Gormley PK (1986) Surgical management of labyrinthine fistula with cholesteatoma. J Laryngol Otol 100(10):1115–1123

    Article  CAS  PubMed  Google Scholar 

  23. Ritter FN (1970) Chronic suppurative otitis media and the pathologic labyrinthine fistula. Laryngoscope 80(7):1025–1035. doi:10.1288/00005537-197007000-00001

    Article  CAS  PubMed  Google Scholar 

  24. Mustafa A, Heta A, Kastrati B, Dreshaj S (2008) Complications of chronic otitis media with cholesteatoma during a 10-year period in Kosovo. Eur Arch Oto-Rhino-Laryngol 265(12):1477–1482. doi:10.1007/s00405-008-0707-8

    Article  CAS  Google Scholar 

  25. Alzoubi FQ, Odat HA, Al-Balas HA, Saeed SR (2009) The role of preoperative CT scan in patients with chronic otitis media. Eur Arch Oto-Rhino-Laryngol 266(6):807–809. doi:10.1007/s00405-008-0814-6

    Article  Google Scholar 

  26. Rogha M, Hashemi SM, Mokhtarinejad F, Eshaghian A, Dadgostar A (2014) Comparison of preoperative temporal bone CT with intraoperative findings in patients with cholesteatoma. Iran J Otorhinolaryngol 26(74):7–12

    PubMed  PubMed Central  Google Scholar 

  27. Choi SA, Kang HM, Byun JY, Park MS, Yeo SG (2014) Analysis of differences in facial nerve dehiscence and ossicular injury in chronic otitis media and cholesteatoma. Acta Otolaryngol 134(5):455–461. doi:10.3109/00016489.2013.860654

    Article  PubMed  Google Scholar 

  28. Genc S, Genc MG, Arslan IB, Selcuk A (2013) Coexistence of scutum defect and facial canal dehiscence. Eur Arch Oto-Rhino-Laryngology. doi:10.1007/s00405-013-2479-z

    Google Scholar 

  29. Harvey SA, Fox MC (1999) Relevant issues in revision canal-wall-down mastoidectomy. Otolaryngology Head Neck Surg 121(1):18–22

    Article  CAS  Google Scholar 

  30. Shinnabe A, Yamamoto H, Hara M, Hasegawa M, Matsuzawa S, Kanazawa H, Yoshida N, Iino Y (2013) Differences in clinical characteristics of fallopian canal dehiscence associated with pars flaccida and pars tensa cholesteatomas. Eur Arch Oto-Rhino-Laryngol. doi:10.1007/s00405-013-2713-8

    Google Scholar 

  31. Sheehy JL, Brackmann DE, Graham MD (1977) Cholesteatoma surgery: residual and recurrent disease. A review of 1,024 cases. Ann Otol Rhinol Laryngol 86(4 Pt 1):451–462

    Article  CAS  PubMed  Google Scholar 

  32. Choung YH, Park K, Cho MJ, Choung PH, Shin YR, Kahng H (2006) Systematic facial nerve monitoring in middle ear and mastoid surgeries: “surgical dehiscence” and “electrical dehiscence”. Otolaryngol Head Neck Surg 135(6):872–876. doi:10.1016/j.otohns.2006.04.008

    Article  PubMed  Google Scholar 

  33. Yadav SP, Ranga A, Sirohiwal BL, Chanda R (2006) Surgical anatomy of tympano-mastoid segment of facial nerve. Indian J Otolaryngol Head Neck Surg 58(1):27–30. doi:10.1007/bf02907734

    PubMed  PubMed Central  Google Scholar 

  34. Isaacson B, Vrabec JT (2007) The radiographic prevalence of geniculate ganglion dehiscence in normal and congenitally thin temporal bones. Otol Neurotol 28(1):107–110. doi:10.1097/01.mao.0000235968.53474.77

    Article  PubMed  Google Scholar 

  35. Palva T, Karja J, Palva A (1971) Opening of the labyrinth during chronic ear surgery. Arch Otolaryngol (Chicago, Ill: 1960) 93(1):75–78

    Article  CAS  Google Scholar 

  36. Copeland BJ, Buchman CA (2003) Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol 24(1):51–60. doi:10.1053/ajot.2003.10

    Article  PubMed  Google Scholar 

  37. Lee JH, Jung SH, Park CH, Hong SM (2009) Bilateral promontory fistula due to noncholesteatomatous chronic otitis media. Eur Arch Oto-Rhino-Laryngol 266(6):933–936. doi:10.1007/s00405-008-0759-9

    Article  Google Scholar 

  38. Prasannaraj T, De NS, Narasimhan I (2003) Aural polyps: safe or unsafe disease? Am J Otolaryngol 24(3):155–158

    Article  PubMed  Google Scholar 

  39. Greenberg JS, Manolidis S (2001) High incidence of complications encountered in chronic otitis media surgery in a U.S. metropolitan public hospital. Otolaryngol Head Neck Surg 125(6):623–627. doi:10.1067/mhn.2001.120230

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the Vice Chancellor of Research of Shiraz University of Medical Sciences for their financial support. We would like to express our special thanks to Mohammad Hashem Zare, due to this research was undertaken as part of undergraduate thesis of him, in Shiraz University of Medical Sciences. We also greatly appreciate Ali Ahmadifar, Maryam Ahmadifar, Manzar Sobhani, Marziye Izadi and Afrooz Eskandarie for data gathering. Also, the authors would like to thank Dr. Nasrin Shokrpour at the Center for Development of Clinical Research of Nemazee Hospital for editorial assistance.

Funding

The study was approved by the local institutional review board of Shiraz University of Medical Sciences.

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Authors and Affiliations

  1. Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran

    Mohammad Faramarzi

  2. Vice Chancellery of Research and Technology, Center for Development of Clinical Studies of Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Sareh Roosta

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  1. Mohammad Faramarzi
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Correspondence to Sareh Roosta.

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Ethical approval

This study was approved by the ethics committee of Shiraz University of Medical Sciences (Approval No. 88-6384).

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Faramarzi, M., Roosta, S. Incidence of Facial Nerve Canal Dehiscence in Primary and Revision Cholesteatoma Surgery. Indian J Otolaryngol Head Neck Surg 69, 300–306 (2017). https://doi.org/10.1007/s12070-017-1094-5

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  • DOI: https://doi.org/10.1007/s12070-017-1094-5

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