Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T03:24:44.433Z Has data issue: false hasContentIssue false

The use of a CT scan to predict the feasibility of decompression of the first segment of the facial nerve via the transattical approach

Published online by Cambridge University Press:  29 June 2007

M. Pellicer*
Affiliation:
Department of Otolaryngology, School of Medicine, Autonomous University of Barcelona, Viladomat 161, 08015 Barcelona, Spain.
P. Quesada
Affiliation:
Department of Otolaryngology, School of Medicine, Autonomous University of Barcelona, Viladomat 161, 08015 Barcelona, Spain.
*
Dr M. Pellicer, Department of Otolaryngology, School of Medicine, Autonomour University of Barcelona, Viladomat 161, 08015 Barcelona, Spain.

Abstract

Total surgical decompression of the facial nerve can be offered to patients severely affected by Bell's palsy whether via the transattical or middle fossa approach. We prefer, when feasible, the transattical approach because it does not violate the cranial vault. The purpose of this study was to find the anatomical parameter of the temporal bone, measured by means of computed tomography (CT scan) and to decide which of these approaches should be offered. Sixty temporal bones were studied by CT scan, and then dissected in order to perform total facial nerve decompression via the transattical approach. Correlation between the two studies was established. Results suggest that measurement by CT scan of the attical area in the axial plane (AAA) may determine those patients for whom the transattical approach to facial nerve decompression should be undertaken.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bradley, A. J. (1991) Imaging of the temporal bone. Current Opinion in Radiology 3: 357.Google Scholar
Cornfield, J. (1962) Joint dependence of risk of coronary heart disease on serum cholesterol and systolic blood pressure: a discriminating function analysis. Federation Proceedings 2: 258.Google Scholar
Engelman, L. (1988) Stepwise logistic regression. In BMDP Statistical Software. (Dixon, W. J., ed.). Vol 2. University of California Press, Berkeley, pp 941969.Google Scholar
Fisch, U. (1969) Die totale freilegung des nervus facialis bei laterobasalem schadel fractusen. Medizin und Hygiene 28 (889): 1206.Google Scholar
Fisch, U., Esslen, E. (1972) Total intratemporal exposure of the facial nerve. Pathology findings in Bell's palsy. Archives of Otolaryngology 95: 95335.Google ScholarPubMed
Fisch, U. (1981) Surgery for Bell's palsy. Archives of Otolaryngology 107: 107–1.Google ScholarPubMed
Gordon, T. (1974) Hazards in the use of the logistic function. Journal of Chronic Diseases 27: 2797.Google ScholarPubMed
Hosmer, D. W. Jr, Lemeshow, S. (1989) Applied Logistic Regression. John Wiley, New York, pp 2527.Google Scholar
Jackler, R. K. (1988) CT and MRI of the ear and temporal bone: current state of the art and future prospects. American Journal of Otology 9 (3): 232239.Google ScholarPubMed
Marsh, M. A., Coker, N. J. (1991) Surgical decompression of idiopathic facial palsy. Otolaryngologic Clinics of North America 24(3): 675689.CrossRefGoogle ScholarPubMed
May, M. (1979) Total facial nerve exploration: transmastoid, extralabyrinthine, and subtemporal. Indications and results. Laryngoscope 89: 89906.CrossRefGoogle Scholar
Müren, C, Wilbrand, H. (1986) The semicircular canals of the inner ear and pneumatization of the temporal bone: a radioanatomic investigation. Acta Radiologica Diagnosis 27 (Fasc 3): 2529.Google ScholarPubMed
Nyberg, P., Fisch, U. (1984) Surgical treatment and results of idiopathic recurrent facial palsy. In Facial Nerve. (Portmann, M., ed.), Masson, New York, pp 312324.Google Scholar
Proctor, B. (1991) The anatomy of the facial nerve. Otolaryngologic Clinics of North America 24 (3): 479504.CrossRefGoogle ScholarPubMed
Salaverry, M. A. (1974) Transattical approach: a technical variation for total decompression of the facial nerve. Revista Brasileira Otorrhinolaryngologia 40: 40262.Google Scholar
Salaverry, M. A. (1982) Transattical approach to the labyrinthine segment of the facial nerve. In Disorders of the facial nerve. (Graham, M. D., House, W. F., eds.), Raven Press, New York, pp 423430.Google Scholar
Swartz, J. D. (1989) Current imaging approach to the temporal bone. Radiology 171: 171309.CrossRefGoogle ScholarPubMed
Wadin, K., Thomander, L., Wilbrand, H. (1987) The laby-rinthine portion of the facial canal in patients with Bell's palsy investigated by computed tomography. Acta Radi-ologica 28(Fasc 1): 2529.CrossRefGoogle ScholarPubMed