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[Mastoid pneumatization in otosclerosis].

With the use of planimetry, and ears lateral projection X-ray pictures, the size of temporal bones pneumatization surfaces was measured 88 ears with otosclerosis and 88 healthy ears were examined. The degree of pneumatization in the two groups was compared. Statistically significantly highly pneumatization was found in the group of ears with otosclerosis.

Adolescent↗

Mastoid emissary in man. An anatomical-clinical study.

The purpose of the study was establishing differences in the situation of the external orifice of the emissary, its size and angle at which it leaves the skull. It is necessary for optimizaing of position for the internal coil of the speech processor of cochlear implant. As yet, the variability of external foramen of this emissary have not been sufficiently studied, especially in the clinical aspect with respect to the use of cochlear implants. The authors examined 200 skulls of adults of both sexes. The statistically significant differences were observed between sexes and between sides of the body, and they showed a definite regularity. The variability of the site of the emissary is presented in a form useful for clinical purposes.

Adult↗

Refined mastoid reconstruction with the pedicled postauricular perichondrial flap.

Successful canal wall reconstruction after open cavity surgery may be compromised by both immediate (graft dehiscence and infection) or delayed (graft retraction, absorption, and extrusion) complications. Many of the healing problems following canal wall reconstruction are related to incomplete soft tissue coverage of the graft and limited blood supply. Under these conditions, we sought to increase graft viability with a broad-based perichondrial flap developed from the posterior surface of the auricle. The flap was used over a period of 3 years at a tertiary referral center in 36 cases of canal wall reconstruction in conjunction with composite grafts of cartilage and perichondrium. The patients ranged in age from 12 to 63 years and in all cases had undergone a canal down tympanomastoidectomy that was reconstructed either primarily or secondarily. The canal wall was successfully reconstructed in 35 of 36 ears. These results demonstrate a reduction in our dehiscence rate from 10 to 3% since the introduction of the perichondrial flap. With the perichondrial flap, we were consistently able to achieve better soft tissue coverage of the composite cartilage graft, eliminate lateral graft dehiscence, and encourage reepithelization of the canal. By implication, we believe this flap provides a source of nutritional support for the free cartilage graft as well as the overlying skin.

Adolescent↗

Acute mastoiditis with complications: a report of two cases.

The authors report two cases of lateral sinus thrombosis (LST) which were recently observed after more than a 20-year absence of such pathology at their Institutions. After reviewing the epidemiologic data, the clinical observations are described in detail. Changes in symptomatology mainly due to the improper use of antibiotics are then discussed as well as the diagnostic improvement offered by modern imaging techniques. Problems still under debate concern the therapeutic strategy: internal jugular vein ligation or anticoagulation therapy versus aminoglycoside administration for patients refractory to the conventional antibiotic therapy. The necessity of close cooperation between general practitioner, pediatrician and otolaryngologist is stressed.

Acute Disease↗