The Value of Computed Tomography Scanning in Assessment of Aditus ad Antrum Patency and Choice of Treatment Line in Revision Myringoplasty
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- Category: Vol. 77, September 2009
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The Value of Computed Tomography Scanning in Assessment of Aditus ad Antrum Patency and Choice of Treatment Line in Revision Myringoplasty,AHMAD S. EL-KADY, YASSER HAROUN, KASSEM M. KASSEM and OSAMA GALAL
Abstract
Objectives: The present study was designed to detect the value of CT imaging in assessment of aditus ad antrum patency and to correlate the radiological findings with operative findings.
Patients and Methods: This study was conducted on 40 patients with failed myringoplasty. All patients underwent full history taking, complete clinical otorhinolaryngological examination and preoperative laboratory investigations. The patients were selected with the following criteria: Previous myringoplasty without mastoidectomy, dry safe perforation in pars tensa, intact ossicular chain, good Eustachian tube (E.T) function and no cartilage graft in the previous operation. CT scanning with 2mm slice thickness and 2mm intervals was done preoperatively for all patients for assessment of the tympanomastoid preumatization and condition of aditus. All patients underwent cortical mastoidectomy operation with underlay myringoplasty with tragal cartilage pericondrium graft. Patients were examined with the use of an operating microscope and otoscope weekly for two months till the ear was completely healed.
Results: The study included 40 patients, 23 males and 17 females with mean age of 29.3 years. CT scanning detected 29 cases (72.5%) with blocked aditus ad antrum and 11 cases (27.5%) with opened aditus ad antrum and these results coincided with the operative finding with CT accuracy of 100%. Only one case presented by failed myringoplasty out of 40 patients from the group of opened aditus ad antrum.
Conclusion: The CT scanning is very effective and accurate tool in evaluation of aditus ad antrum blockage and this blockage play a role in failure of myringoplasty. It is recom-mended that CT scanning should be done for every patient with simple myringoplasty before operation to decrease time consuming, avoid complications of cortical mastoidectomy and decrease the rate of failure of operation, as it gives accurate idea about the choice of the correct line of treatment, if the patient necessitate cortical mastoidectomy operation or not.