Arquivos Internacionais de Otorrinolaringologia 2012; 16(01): 057-061
DOI: 10.7162/S1809-48722012000100008
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Mastoidectomy: anatomical parameters x surgical difficulty

Mastoidectomia: parâmetros anatômicos x dificuldade cirúrgica
Anastácio Rodrigues Pereira Júnior
1   Post Graduated in Otorhinolaryngology. Otorhinolaryngologist from SESI.
,
Sebastião Diógenes Pinheiro
2   Ph.D. in Otorhinolaryngology by Medical School from Universidade de São Paulo. Chief of Service from Otorhinolaryngology from Medical School from Universidade Federal do Ceará.
,
José Daniel Vieira de Castro
3   Ph.D. in Clinical Medicine by the Medical School from Ribeirão Preto from Universidade de São Paulo. Associate Professor from the Clinical Medicine from Medical School from Universidade Federal do Ceará.
,
João Aragão Ximenes Filho
4   Ph.D. in Otorhinolaryngology by Medical School from Universidade de São Paulo. Associate Professor from the Departament of Surgery from Medical School of Universidade Federal do Ceará.
,
Marcos Rabelo de Freitas
5   Ph.D. in Surgery by Universidade Federal do Ceará. Post Doctorate in the Otologic Group from Piacenza, Italy. Associate Professor in Otorhinolaryngology by Medical School from Universidade Federal do Ceará.
› Author Affiliations
Further Information

Publication History

01 June 2011

25 June 2011

Publication Date:
12 February 2014 (online)

Summary

Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy.

Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy.

Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n = 30).

Form of study: Contemporary cohort transverse.

Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2) or temporal meninges prolapse (n = 7) or both (n = 1). In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm.

Conclusion:The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

Resumo

Introdução: A meninge temporal rebaixada e o/ou seio sigmoide anteriorizado são condições que podem determinar dificuldades cirúrgicas na realização da mastoidectomia.

Objetivo: Correlacionar a medida do prolapso do seio sigmoide e da meninge temporal na tomografia com a dificuldade cirúrgica na mastoidectomia.

Método: As medidas tomográficas de prolapso sigmóideo e da meninge temporal foram correlacionadas com presença ou não de dificuldade cirúrgica observados durante o procedimento mastoidectomia de pacientes com otomastoidite crônica (n = 30).

Forma de estudo: Coorte contemporânea com corte transversa.

Resultados: Em 10 pacientes, observou-se dificuldade cirúrgica assim distribuída: devido ao prolapso do seio sigmoide (n = 2) ou prolapso da meninge temporal (n = 7) ou ambos (n = 1). Nos pacientes cuja dificuldade cirúrgica foi devido ao prolapso do seio sigmoide, a distância na tomografia da borda anterior do seio sigmoide à parede posterior do canal auditivo externo foi menor que 9 mm. Nos pacientes cuja dificuldade cirúrgica foi devido ao prolapso da meninge temporal, a distância tomográfica desta ao plano superior do osso petroso foi 7 mm.

Conclusão: A distância na tomografia computadorizada entre a meninge temporal e o plano superior do osso petroso 7 mm e uma distância do bordo anterior do seio sigmoide à parede posterior do canal auditivo externo inferior a 9 mm são preditivos de dificuldades cirúrgicas durante a mastoidectomia.

 
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