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Mei H, Lu X, Dong C, Lin H, Chen B, Li H, Ni Y. Combined microscope-endoscopy resection of petrous bone cholesteatoma with temporary facial nerve transposition versus nontransposition. Eur Arch Otorhinolaryngol 2024; 281:2905-2912. [PMID: 38227283 PMCID: PMC11065940 DOI: 10.1007/s00405-023-08397-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/04/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE The narrow supralabyrinthine space affects surgical procedures. To study the effect of temporary transposition of geniculate ganglion of facial nerve versus nontransposition on lesion recurrence and facial nerve function in patients with petrous bone cholesteatoma. METHODS A total of 18 patients with petrous bone cholesteatoma involving the facial nerve were treated in our hospital from November 2016 to March 2023. The main surgical method is the extended supralabyrinthine approach assisted by a microscope and an endoscope. We collected and retrospectively analyzed their medical records. RESULTS Temporary facial nerve transposition was performed in five patients, and nontransposition was performed in 13 patients. Cholesteatoma recurred in three patients with facial nerve nontransposition, whereas none in patients with facial nerve transposition. In this study, except for one case with a second operation, postoperative facial paralysis in other cases was improved to varying degrees, and there was no significant difference between the two groups. CONCLUSION Temporary transposition of geniculate ganglion of facial nerve will not affect the postoperative nerve function of patients and can reduce the possibility of cholesteatoma recurrence of the petrous bone.
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Affiliation(s)
- Honglin Mei
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
| | - Xiaoling Lu
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
| | - Chunguang Dong
- Department of Otorhinolaryngology, First People's Hospital of Lianyungang, Jiangsu, 222002, China
| | - Hailiang Lin
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
| | - Bing Chen
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
| | - Huawei Li
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China.
| | - Yusu Ni
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China.
- Otology and Skull Base Surgery, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China.
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Lu X, Mei H, Zhao W, Ni Y. Feasibility Analysis and Surgical Details of Vestibular Schwannoma Resection via Retrolabyrinthine Approach With Preservation of Endolymphatic Sac. EAR, NOSE & THROAT JOURNAL 2023:1455613231190505. [PMID: 37551675 DOI: 10.1177/01455613231190505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Objectives: To study the feasibility of reserving the endolymphatic sac in the cerebellopontine angle (CPA) and the fundus of the internal auditory canal (IAC) by the retrolabyrinthine approach. Design: Single-center retrospective study. Methods: Through 3-dimensional preoperative computed tomography reconstruction, vestibular schwannoma (VS) resection was performed using a retrolabyrinthine approach with preservation of the endolymphatic sac in selected patients, and hearing and facial nerve functions were followed to assess the feasibility of this operation and the effectiveness of function preservation. Results: VS was completely removed in all cases and the postoperative detectable hearing retention rate (AAO-HNS hearing rating grade A, B, and C) was 80% (4/5). Postoperative facial nerve function was well preserved (HB grade I), no leakage of cerebrospinal fluid or other cranial complications was observed in all patients, and no recurrence was observed during follow-up. Conclusions: With less trauma and a promising route for hearing preservation and facial nerve functions, the retrolabyrinthine approach is a potential choice for the treatment of VS located in the IAC-CPA.
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Affiliation(s)
- Xiaoling Lu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Honglin Mei
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
| | - Weidong Zhao
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
- Otology and Skull Base Surgery Department, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yusu Ni
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, China
- Otology and Skull Base Surgery Department, Eye & ENT Hospital, Fudan University, Shanghai, China
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Zou J, Lähelmä J, Arnisalo A, Pyykkö I. Clinically relevant human temporal bone measurements using novel high-resolution cone-beam CT. J Otol 2017; 12:9-17. [PMID: 29937832 PMCID: PMC6011811 DOI: 10.1016/j.joto.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/12/2017] [Accepted: 01/16/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To test the feasibility of measuring fine temporal bone structures using a newly established cone-beam computed tomography (CBCT) system. MATERIALS AND METHODS Six formalin-fixed human cadaver temporal bones were imaged using a high-resolution CBCT system that has 900 frames and copper + aluminum filtration. Fine temporal bone structures, including those of the facial nerve canal and vestibular structures, were identified and measured. RESULTS The fine structures of the middle ear, including the tympanic membrane, tendon of the tensor tympani, cochleariform process of the semicanal of the tensor tympani, pyramidal eminence, footplate of the stapes, full path of the facial nerve within the temporal bone, supralabyrinthine space, semicircular canals, pathway of the subarcuate canal, and full path of the vestibular aqueduct, were clearly demonstrated. The vestibular aqueduct has a midpoint width of 0.4 ± 0.0 mm and opercular width of 0.5 ± 0.1 mm (mean ± SD). The length of the internal acoustic meatus was 10.6 ± 1.2 mm (mean ± SD), and the diameter of the internal acoustic meatus was 3.7 ± 0.3 mm (mean ± SD). CONCLUSION This novel high-resolution CBCT system has potentially broad applications in the diagnosis of inner ear disease and in monitoring associated pathological changes, surgical planning, navigation for the ear surgery, and temporal bone training.
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Affiliation(s)
- Jing Zou
- Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
| | | | - Antti Arnisalo
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland
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