Skip to main content
Log in

Incidence of fallopian canal dehiscence at surgery for chronic otitis media

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The objectives of this study were to determine the incidence and locations of dehiscence of the fallopian canal (FC) in patients undergoing surgery for different middle ear pathologies and to describe the findings that will aid in pre-operative prediction of dehiscence. Charts and operative details of the 118 ears managed with canal wall-down and 147 ears managed with canal wall-up tympanomastoidectomy performed by a single surgeon were retrospectively reviewed. The distribution of the diagnoses for ears that were operated was as follows: 118 ears cholesteatoma, 42 ears adhesive otitis, 23 ears tympanosclerosis, and 82 ears chronic otitis media. The presence and the location of facial nerve dehiscence after exenteration of the disease as well as the presence of any coexisting inner ear fistula and dural defect were noted. FC dehiscence was observed in 56 of the cases. The incidence of dehiscence was highest among ears with cholesteatoma (n = 44, P < 0.05). Adults and also male patients in the study had significantly higher incidence of dehiscence compared to pediatric (P < 0.05) and female (P < 0.01) patients. The most common location for dehiscence was the tympanic segment which was significantly higher than the other locations (P < 0.01). Among the ears with FC dehiscence, labyrinthine fistula presence was seen in ten ears which was also significant (P < 0.001). Patients with dural exposure were 12.06 times more likely to have FC dehiscence than those without dural exposure. The incidence of FC dehiscence was 1.26 times higher in revision operations, but the difference was not significant (P > 0.05). An otologic surgeon should be more careful while performing operation for cholesteatoma in an adult and male patient because of the high incidence of dehiscence observed in these ears. Presence of lateral semicircular canal fistula and erosion of the bony tegmen should also be considered as a clue for the presence of dehiscence before surgery. Operation of these ears should be performed by experienced surgeons in otology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nilssen EL, Wormald PJ (1997) Facial nerve palsy in mastoid surgery. J Laryngol Otol 111:113–116. doi:10.1017/S0022215100136618

    Article  PubMed  CAS  Google Scholar 

  2. Altuntas A, Unal A, Aslan A, Ozcan M, Kurkcuoglu S (1998) Facial nerve paralysis in chronic suppurative otitis media: Ankara Numune Hospital experience. Auris Nasus Larynx 25:169–172. doi:10.1016/S0385-8146(98)00002-9

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  4. Wiet RJ (1982) Iatrogenic facial paralysis. Otolaryngol Clin North Am 15:773–780

    PubMed  CAS  Google Scholar 

  5. Uno Y, Saito R (1995) Bone resorption in human cholesteatoma: morphological study with scanning electron microscopy. Ann Otol Rhinol Laryngol 104:463–468

    PubMed  CAS  Google Scholar 

  6. Di Martino E, Sellhaus B, Haensel J (2005) Fallopian canal dehiscences: a survey of clinical and anatomical findings. Eur Arch Otorhinolaryngol 262:120–126. doi:10.1007/s00405-004-0867-0

    Article  PubMed  Google Scholar 

  7. Moreano EH, Paparella MM, Zelterman D (1994) Prevalence of facial canal dehiscence and of persistent stapedial artery in the human middle ear: a report of 1000 temporal bones. Laryngoscope 104:309–320

    PubMed  CAS  Google Scholar 

  8. Daniels RL, Krieger LW, Lippy WH (2001) The other ear: findings and results in 1, 800 bilateral stapedectomies. Otol Neurotol 22:603–607. doi:10.1097/00129492-200109000-00007

    Article  PubMed  CAS  Google Scholar 

  9. Harvey SA, Fox MC (1999) Relevant issues in revision canal-wall-down mastoidectomy. Otolaryngol Head Neck Surg 121:18–22. doi:10.1016/S0194-5998(99)70116-6

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Selesnick SH, Lynn-Macrae AG (2001) The incidence of facial nerve dehiscence at surgery for cholesteatoma. Otol Neurotol 22:129–132. doi:10.1097/00129492-200103000-00002

    Article  PubMed  CAS  Google Scholar 

  13. Baxter A (1971) Dehiscence of the fallopian canal: an anatomical study. J Laryngol Otol 85:587–594. doi:10.1017/S0022215100073849-&gt;

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  15. 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 116:800–803. doi:10.1258/00222150260293600

    Article  PubMed  Google Scholar 

  16. Dornhoffer JL (2000) Surgical management of the atelectatic ear. Am J Otol 21:315–321. doi:10.1016/S0196-0709(00)80038-1

    Article  PubMed  CAS  Google Scholar 

  17. Green JD Jr, Shelton C, Brackmann DE (1994) Iatrogenic facial nerve injury during otologic surgery. Laryngoscope 104:922–926

    PubMed  Google Scholar 

  18. Kaneko Y, Yuasa R, Ise I (1980) Bone destruction due to the rupture of a cholesteatoma sac: a pathogenesis of bone destruction in aural-cholesteatoma. Laryngoscope 90:1865–1871. doi:10.1288/00005537-198011000-00015

    Article  PubMed  CAS  Google Scholar 

  19. Moriyama H, Honda Y, Huang CC (1987) Bone resorption in cholesteatoma: epithelial–mesenchymal cell interaction and collagenase production. Laryngoscope 97:854–859. doi:10.1288/00005537-198707000-00016

    Article  PubMed  CAS  Google Scholar 

  20. Orisek BS, Chole RA (1987) Pressures exerted by experimental cholesteatomas. Arch Otolaryngol Head Neck Surg 113:386–391

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cem Ozbek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ozbek, C., Tuna, E., Ciftci, O. et al. Incidence of fallopian canal dehiscence at surgery for chronic otitis media. Eur Arch Otorhinolaryngol 266, 357–362 (2009). https://doi.org/10.1007/s00405-008-0748-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-008-0748-z

Keywords

Navigation