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Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 7 - Otology/Neurotology

Radiological Characteristics of Tympanomastoid Complex for Mastoid Cavity Obliteration

Tuesday, October 1, 2024
8:36 AM – 8:42 AM EDT
Location: MBCC, 231
Disclosure(s):
Gaurav Kumar, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mohamed Amin, MSc, MRCS ENT:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jabin Thaj, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Sachin C. Patil, FRCS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Nilima P. Ghadge, MRCS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Chronic otitis media, particularly the squamous type, often presents with chronic hypoventilation of the middle ear cleft, resulting in a shrunken and sclerotic mastoid. However, the mastoid system's anatomical variation can be extensive and may necessitate diverse surgical approaches following Cortical Mastoidectomy with Mastoid Cavity Obliteration (CWD). This pilot study aims to explore the radiological characteristics of the otomastoid complex, guiding surgical planning for mastoid cavity obliteration.

Methods: The source of data was a list of patients referred for CT temporal bone in the past two years. This was a retrospective study of 300 patients from January 2021 to January 2023. Inclusion criteria was all temporal bone CT scans without evidence of ear surgery and exclusion criteria was ear surgery and neoplasms. Observational analysis was used.

Results: Variables such as sigmoid plate, dural plate, sinodural angle, sinus plate-PCW distance, mastoid tip cells, cavity size, recess, and sump are crucial in determining mastoid cavity configuration. There are 6 scenarios (I to VI) represent common patterns observed in the otomastoid complex. The height of the facial ridge is inversely proportional to the experience and confidence of the operating surgeon. There are 4 types of Palva flap (Superior, Anterior, Inferior, and Posterior) with specific reconstruction approaches for each scenario.

Conclusions: Preoperative CT scans of the temporal bone provide valuable insights into postoperative cavity features, aiding in surgical planning. The formulated flap types for each configuration, based on the author's surgical experience, demonstrate a success rate of 99%. Long-term follow-up suggests reliable results and favourable outcomes. This pilot study opens avenues for further research in refining mastoid cavity obliteration strategies.

    Presenting Author(s)

  • Gaurav Kumar, MBBS

    Consultant
    BHRUT
    Hornchurch, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    Resources

    • Co-Author(s)

  • Anjana Sivamani, MS ENT, DNB ENT

    Specialty doctor
    Queens hospital,BHRUT
    LONDON, England, United Kingdom

    Disclosure information not submitted.

  • Mohamed Amin, MSc, MRCS

    Senior Rhinology Fellow
    Queens Hospital, London
    London, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JT

    Jabin Thaj, MBBS

    ENT/Head and Neck Consultant
    BHRUT
    Essex, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Sachin C. Patil

    Consultant
    BHRUT
    Ipswich, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Nilima P. Ghadge, MRCS

    Speciality Doctor
    Queen's Hospital
    London, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.