Shahid Rasool*, Richa Garg, Ayushi Tandon, Shreya Khatri, Ratna Priya, Junaid Malik, Seema Monga, and Khaja Naseeruddin
Department of ENT and HNS, Hamdard Institute of Medical Sciences and Associated HAHC Hospital, IndiaFulltext PDF
Dehiscence of the facial canal is a matter of great concern for an otologist as one of the most dread complications of mastoid surgery is injury to the facial nerve. Dehiscence can be congenital or acquired. Congenital fallopian canal dehiscence is a developmental defect of the bony covering of facial nerve which usually involves the tympanic segment of the canal in almost 60% of the cases. While as Acquired cases are most commonly associated with squamousal chronic otitis media or cholesteatoma. The incidence of facial injury in cholesteatoma surgery is approximately as 1% to 2%. Objectives: To find the true intraoperative incidence of Facial Canal Dehiscence (FCD) in squamousal chronic otitis media and compare the results with homogenous control group. The second aim of the study is to determine the labyrinthine fistula in presence of FCD. Methods: Total of 175 patients of chronic otitis media was enrolled in the study. The study group consisted of 100 cases of COM with cholesteatoma and control group consisted of 75 cases of Mucosal COM. Results: Of total of 100 cases of cholesteatoma group 9% had FCD. While as in control group only 1.3% had FCD. Which was statistically significant (p=0.03). It was found that ears with both cholesteatoma & FCD had higher intraoperative incidence of labyrinthine fistulas (44%) compared to those where only cholesteatoma was seen. Which was highly statistical significant (p-value of 0.000001)? Conclusion: There is a potential causal relationship between cholesteatoma & facial canal dehiscence. The presence of facial canal dehiscence markedly increases the chances of labyrinthine fistulas.
Facial canal dehiscence; Cholesteatoma; Labyrinthine fistula; LSCC fistula
Rasool S, Garg R, Tandon A, Khatri S, Priya R, Malik J, et al. Cholesteatoma and Facial Canal Dehiscence: A Comparative Prospective Study. Am J Otolaryngol Head Neck Surg. 2020;3(2):1086.