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Intraoperative endoscopy of the anterior epitympanum recess through the posterior tympanotomy

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media.

Aim: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: retrospective analysis of intraoperative search.

Material and methods: The study included 55 patients treated in the Department of Otolaryngology, Medical University of Warsaw within the years 2009–2011, who underwent endoscopy-assisted canal wall up tympanoplasty with posterior tympanotomy. The type of construction of the AER – cellular or dome-shaped – was determined.

Results: Cellular type of recess was found intraoperatively in 32% of ears and dome-shaped in 68% of the study group. The population with chronic otitis media does not differ significantly compared to the general population in terms of the construction of the anterior epitympanum recess (p = 0.668108; χ2 = 0.1838235, df = 1). Among the ears with cholesteatoma a cellular AER was found in 48.3% of cases and a dome-shaped AER was found in 51.7%.

Conclusions: The cellular type of AER was significantly more frequent in ears with cholesteatoma (p < 0.01, χ2 = 29.86492, df = 1). Level of evidence: 1b.

No MeSH data available.


Related in: MedlinePlus

Anterior epitympanic recess of cellular structure – view from the endoscope 30° by the posterior tympanotomy (right ear – view from the posterior epitympanotomy)
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f0002: Anterior epitympanic recess of cellular structure – view from the endoscope 30° by the posterior tympanotomy (right ear – view from the posterior epitympanotomy)

Mentions: The anterior epitympanic recess (AER) is separated from the posterior epitympanum by a cog, descending from the tegmen tympani and the vertically extending mucosal fold. The superior and anterior epitympanic compartment, or the air space in the front of the head of the malleus, is called variously by different authors: sinus epitympani [2], anterior epitympanic recess/compartment [3–5], anterior attic recess [6] or geniculate sinus [7]. Medial to the AER lies the inferior part of the geniculate and the anterior part of the tympanic section of the facial nerve. In the anterior-lateral direction, this space is adjacent to the petro-tympanic fissure, in which lies the chorda tympani. The bone structure of the AER is differentiated. This structure may be a single air chamber of a hemispherical dome shape (Photo 1) which was found in about 50% of the population bilaterally. In another version AER consists of a system of many small air cells (Photo 2). Such a cellular construction bilaterally was found in approximately 28% of the population. Other people have a different structure of the AER on each side [8].


Intraoperative endoscopy of the anterior epitympanum recess through the posterior tympanotomy
Anterior epitympanic recess of cellular structure – view from the endoscope 30° by the posterior tympanotomy (right ear – view from the posterior epitympanotomy)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5095271&req=5

f0002: Anterior epitympanic recess of cellular structure – view from the endoscope 30° by the posterior tympanotomy (right ear – view from the posterior epitympanotomy)
Mentions: The anterior epitympanic recess (AER) is separated from the posterior epitympanum by a cog, descending from the tegmen tympani and the vertically extending mucosal fold. The superior and anterior epitympanic compartment, or the air space in the front of the head of the malleus, is called variously by different authors: sinus epitympani [2], anterior epitympanic recess/compartment [3–5], anterior attic recess [6] or geniculate sinus [7]. Medial to the AER lies the inferior part of the geniculate and the anterior part of the tympanic section of the facial nerve. In the anterior-lateral direction, this space is adjacent to the petro-tympanic fissure, in which lies the chorda tympani. The bone structure of the AER is differentiated. This structure may be a single air chamber of a hemispherical dome shape (Photo 1) which was found in about 50% of the population bilaterally. In another version AER consists of a system of many small air cells (Photo 2). Such a cellular construction bilaterally was found in approximately 28% of the population. Other people have a different structure of the AER on each side [8].

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media.

Aim: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: retrospective analysis of intraoperative search.

Material and methods: The study included 55 patients treated in the Department of Otolaryngology, Medical University of Warsaw within the years 2009–2011, who underwent endoscopy-assisted canal wall up tympanoplasty with posterior tympanotomy. The type of construction of the AER – cellular or dome-shaped – was determined.

Results: Cellular type of recess was found intraoperatively in 32% of ears and dome-shaped in 68% of the study group. The population with chronic otitis media does not differ significantly compared to the general population in terms of the construction of the anterior epitympanum recess (p = 0.668108; χ2 = 0.1838235, df = 1). Among the ears with cholesteatoma a cellular AER was found in 48.3% of cases and a dome-shaped AER was found in 51.7%.

Conclusions: The cellular type of AER was significantly more frequent in ears with cholesteatoma (p < 0.01, χ2 = 29.86492, df = 1). Level of evidence: 1b.

No MeSH data available.


Related in: MedlinePlus