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Zhang Z, Tang R, Wu Q, Zhao P, Yang Z, Wang Z. An exploratory study of imaging diagnostic clues for overhanging facial nerve in ultra-high-resolution CT. Eur Arch Otorhinolaryngol 2023; 280:3643-3651. [PMID: 36847878 PMCID: PMC10313554 DOI: 10.1007/s00405-023-07879-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/08/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Overhanging facial nerve (FN) may be challenging in imaging diagnosis. The purpose of the study is to investigate the imaging clues for overhanging FN near the oval window on ultra-high-resolution computed tomography (U-HRCT) images. METHODS Between October 2020 and August 2021, images of 325 ears (276 patients) were included in the analysis obtained by an experimental U-HRCT scanner. On standard reformatted images, the morphology of FN was evaluated and its position was quantitatively measured using the following indices: protrusion ratio (PR), protruding angle (A), position of FN (P-FN), distance between FN and stapes (D-S), and distance between FN and anterior and posterior crura of stapes (D-AC and D-PC). According to the FN morphology in imaging, images were divided into overhanging FN group and non-overhanging FN group. Binary univariate logistic regression analysis was used to identify the imaging indices independently associated with overhanging FN. RESULTS Overhanging FN was found in 66 ears (20.3%), which manifested as downwards protrusion of either local segment (61 ears, 61/66) or the entire course near the oval window (5 ears, 5/66). D-AC [odds ratio: 0.063, 95% CI 0.012-0.334, P = 0.001) and D-PC (odds ratio: 0.008, 95% CI 0.001-0.050, P = 0.000) were identified as independent predictors of FN overhang (area under the curve: 0.828 and 0.865, respectively). CONCLUSION Abnormal morphology of the lower margin of FN, D-AC and D-PC on U-HRCT images provide valuable diagnostic clues for FN overhang.
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Affiliation(s)
- Zhengyu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Western District, Beijing, 100050, China
| | - Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Western District, Beijing, 100050, China
| | - Qian Wu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Western District, Beijing, 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Western District, Beijing, 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Western District, Beijing, 100050, China.
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Tang R, Zhang Z, Zhao P, Zhao L, Xu N, Yin H, Yang Z, Wang Z. A novel imaging scoring method for identifying facial canal dehiscence: an ultra-high-resolution CT study. Eur Radiol 2023; 33:2830-2839. [PMID: 36376528 PMCID: PMC10017601 DOI: 10.1007/s00330-022-09231-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/02/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Facial canal dehiscence (FCD), typically found in the tympanic segment, is a risk factor for facial nerve injury. An imaging scoring method was proposed to identify FCD based on ultra-high-resolution CT. METHODS Forty patients (21 females and 19 males, mean age 44.3 ± 17.4 years), whose tympanic facial canal (FC) was examined during otological surgery, were divided into the FCD group (n = 29) and the control group (n = 11) based on surgical findings. Imaging appearance of tympanic FC was scored 0-3: 0 = no evident bony covering, 1 = discontinuous bony covering with linear deficiency, 2 = discontinuous bony covering with dotted deficiency, and 3 = continuous bony covering. Both lateral and inferior walls were assigned a score as LFCD and IFCD, respectively. An FCD score was calculated as LFCD + IFCD. The diagnostic value of the FCD score was tested using the ROC curve. RESULTS The inter-observer agreement was moderate for the lateral wall (Cohen's κ coefficient 0.416, 95% CI 0.193-0.639), and good for the inferior wall (Cohen's κ coefficient 0.702, 95% CI 0.516-0.888). In the FCD group, the most common appearance for both walls was discontinuous bony covering with linear deficiency (LFCD = 1, 22/29, 75.9%; IFCD = 1, 15/29, 51.7%). An FCD score of less than 4 was associated with high sensitivity (0.82) and specificity (0.93) for identifying FCD, with an AUC of 0.928. CONCLUSIONS Using the proposed scoring method, FCD score < 4 could identify FCD of the tympanic segment with high concordance with surgical findings. KEY POINTS • Imaging appearance of the tympanic facial canal (FC) is divided into four types based on ultra-high-resolution CT images. • The most common appearance of FC with facial canal dehiscence (FCD) is discontinuous bony covering with linear deficiency. • An FCD score, consisting of scores of the lateral and inferior walls, less than 4 is highly indicative of FCD.
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Affiliation(s)
- Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhengyu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Lei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Hongxia Yin
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong'an Road, Xicheng District, Beijing, 100050, People's Republic of China.
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Stapedius muscle: Don't mistake it for a branch of the facial nerve in images. Auris Nasus Larynx 2023:S0385-8146(23)00036-6. [PMID: 36894377 DOI: 10.1016/j.anl.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE The relationship between the stapedius muscle and the vertical part of the facial nerve is important for surgery. The study aims to understand the spatial relationship between the stapedius muscle and the vertical part of the facial nerve in ultra-high-resolution computed tomography (U-HRCT) images. METHODS A total of 105 ears from the heads of 54 human cadavers were analyzed using U-HRCT. The location and direction of the stapedius muscle were evaluated with the facial nerve as the reference. The integrity of the bony septum between the two structures and the distance between the transverse sections were examined. Paired Student's t-test and the nonparametric Wilcoxon test were applied. RESULTS The lower end of the stapedius muscle emerged at the upper (45 ears), middle (40 ears), or lower (20 ears) level of the facial nerve and was positioned medial (32 ears), medial posterior (61 ears), posterior (11 ears), or lateral posterior (1 ear) to the facial nerve. The bony septum was not continuous in 99 ears. The distance between the midpoints of the two structures was 1.75 mm (IQR=1.55-2.16 mm). CONCLUSION The spatial relationship between the stapedius muscle and the facial nerve was varied. They were close to each other and in most cases the bony septum was not intact. Preoperative familiarity with the relationship between the two structures is helpful for avoiding unwanted injury to the facial nerve in surgery.
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Acle-Cervera L, González-Aguado R, Bauer M, Bernal-Lafuente C, Drake-Pérez M, Manrique-Rodríguez M, Marco de Lucas E, Ropero-Romero F, Sambola-Cabrer I, Sánchez-Fernández R, Lassaletta L. Checklist of the temporal bone and lateral skull base CT-scan. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 73:394-405. [DOI: 10.1016/j.otoeng.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/17/2021] [Indexed: 11/06/2022]
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Muñoz-Galván A, Fiori-Chíncaro GA, Agudelo-Botero AM. [Applications of cone beam computed tomography of the craneofacial structure in medical specialties. A review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e100. [PMID: 38389916 PMCID: PMC10880726 DOI: 10.21142/2523-2754-1001-2022-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/01/2022] [Indexed: 02/24/2024] Open
Abstract
Cone-beam computed tomography (CBCT) of the craniofacial structure has demonstrated its usefulness in the dental area during the last decades, thus it has become a fundamental tool in the diagnosis, planning, and evaluation of treatment, and although it was not developed for the exclusive use in dentistry, as it is commonly considered, it is used in other areas such as medicine. It is specifically used in the head and neck area where different medical specialties interact, and at the same time these interact with dental specialties, so knowing the advantages of CBCT over different imaging technologies in the medical area is necessary. The purpose of this review was to describe the applications of observation, diagnosis, planning, and evolution of treatments using maxillofacial HSCT in different medical specialties. This work highlights the use of TCHC in different medical applications and highlights where it is most useful compared to other technologies.
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Affiliation(s)
- Agustín Muñoz-Galván
- Division de Radiologia Bucal y Maxilofacial, Universidad Cientifica del Sur. Lima, Peru. Universidad Científica del Sur Division de Radiologia Bucal y Maxilofacial Universidad Cientifica del Sur Lima Peru
| | - Gustavo Adolfo Fiori-Chíncaro
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
| | - Ana María Agudelo-Botero
- Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE). Lima, Peru. , Instituto Latinoamericano de Altos Estudios en Estomatologia (ILAE) Lima Peru
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Acle-Cervera L, González-Aguado R, Bauer M, Bernal-Lafuente C, Drake-Pérez M, Manrique-Rodríguez M, Marco de Lucas E, Ropero-Romero F, Sambola-Cabrer I, Sánchez-Fernández R, Lassaletta L. Lista de verificación de tomografía computarizada de hueso temporal y base de cráneo lateral. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021. [DOI: 10.1016/j.otorri.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saxby AJ, Jufas N, Kong JHK, Newey A, Pitman AG, Patel NP. Novel Radiologic Approaches for Cholesteatoma Detection: Implications for Endoscopic Ear Surgery. Otolaryngol Clin North Am 2020; 54:89-109. [PMID: 33153729 DOI: 10.1016/j.otc.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Technological advancement in computed tomography (CT) and MRI has improved cholesteatoma detection rates considerably in the past decade. Accurately predicting disease location and extension is essential for staging, planning, and preoperative counseling, in particular in the newer approach of endoscopic ear surgery. Improved sensitivity and specificity of these radiological methods may allow the surgeon to confidently monitor patients, therefore avoiding unnecessary surgery. This article outlines recent advances in CT and MRI technology and advantages and disadvantages of the newer techniques. Emphasis on improving the feedback loop between the radiologist and surgeon will increase the accuracy of these new technologies.
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Affiliation(s)
- Alexander J Saxby
- Department of Otolaryngology-Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Sydney, Australia.
| | - Nicholas Jufas
- Department of Otolaryngology-Head and Neck Surgery, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
| | - Jonathan H K Kong
- Department of Otolaryngology-Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Sydney, Australia
| | - Allison Newey
- Department of Radiology, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
| | - Alexander G Pitman
- Department of Radiology, Northern Beaches Hospital, 105 Frenchs Forest Road W, Frenchs Forest, NSW 2086, Sydney, Australia
| | - Nirmal P Patel
- Department of Otolaryngology-Head and Neck Surgery, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
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