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  • Title: Prevalence of facial canal dehiscence and other bone defects by computed tomography.
    Author: Hernandez-Trejo AF, Cuellar-Calderon KP, Treviño-Gonzalez JL, Yamamoto-Ramos M, Campos-Coy MA, Quiroga-Garza A, Guzman-Avilan K, Elizondo-Riojas G, Elizondo-Omaña RE, Guzman-Lopez S.
    Journal: Eur Arch Otorhinolaryngol; 2020 Oct; 277(10):2681-2686. PubMed ID: 32383094.
    Abstract:
    INTRODUCTION: The facial nerve is the most vulnerable structure during otological surgeries. Facial canal dehiscence (FCD) is the main risk factor for iatrogenic injuries. Its prevalence in clinical studies ranges between 6 and 33.3%, while anatomical studies report 25-57%. The objective was to determine the prevalence of FCD stratified by age and gender in a healthy population. MATERIALS AND METHODS: Temporal bones from high-resolution computed tomography (CT) were analyzed. Patients with a history of trauma or tumors of the temporal bone, cholesteatomas, chronic middle ear disease, and any pathology that could modify the bone's anatomy, were excluded. RESULTS: A total of 184 temporal bones were included. FCD was observed in 94 (51.2%) of the analyzed bones. The tympanic portion was the most frequently affected site with 91 (49.5%), followed by the mastoid segment with 3 (1.6%). No dehiscence was found in the labyrinth portion. We observed 30 (31.9%) of the FCD involved the oval window. Other bone defects identified with the FCD included: 11 (11.7%) with a lateral semicircular canal fistula and 7 (7.4%) with tegmen tympani erosions. CONCLUSION: FCD has a high prevalence among healthy patients. A pre-surgical otological evaluation using high-resolution CT should be indicated to properly assess the patient and reduce the risk of injury.
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