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    Can MDCT Scan of the Temporal Bone Looking at Pneumatization Predict Surgical Vulnerability of the Facial Nerve?
    (SAGE Publications Ltd, 2019) Inal M.; Muluk N.B.; Şahan M.H.; Asal N.; Şimşek G.; Arıkan O.K.
    Objectives: The aim of this study is to investigate the scutum–cochleariform process (CP) and scutum–promontorium distances according to the mastoid pneumatization condition. Methods: Two hundred temporal multidetector computed tomography scans (90 males and 110 females) were evaluated retrospectively. The scutum-CP and scutum–promontorium distances were measured. Facial canal dehiscence (FCD) in the tympanic segment and mastoid pneumatization were also evaluated. Results: The distances between scutum-CP and scutum–promontorium were not different between males and females and between right and left sides. Facial canal dehiscence in the tympanic segment was detected: 5.6% (right) and 7.8% (left) in males and 5.5% (right) and 10.0% (left) in females. Grade 4 (100%) pneumatization was detected mainly in 55.6% to 57.8% of the patients in both genders. Grade 0 (0%) pneumatization (sclerosis) was detected in 22.2% to 28.2% of both males and females. In more pneumatized mastoids, the scutum-CP and scutum–promontorium distances increased. In sclerotic mastoids, the scutum-CP and scutum–promontorium distances decreased. Facial canal dehiscence rates were not related to the mastoid pneumatization levels. Conclusion: Cochleariform process is an important landmark to localize the tympanic segment of the facial canal. In sclerosed mastoids, scutum-CP and scutum–promontorium distances decreased. There was no relationship between FCD rates and mastoid pneumatization levels. It may be due to the development of FCD that occurs during the intrauterine period. In endoscopic and classic ear surgeries, mastoid pneumatization must be evaluated preoperatively to avoid facial nerve injuries. © The Author(s) 2019.
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    Is there a relationship between mastoid pneumatisation and facial canal dimensions?
    (Cambridge University Press, 2019) Inal M.; Bayar Muluk N.; Asal N.; Şahan M.H.; Şimşek G.; Arikan O.K.
    Objective To evaluate mastoid pneumatisation and facial canal dimensions.Method In this retrospective study, 169 multidetector computed tomography scans of temporal bone were reviewed. Facial canal dimensions were evaluated at the labyrinthine, tympanic and mastoid segments using axial and coronal multidetector computed tomography scans of temporal bone. Mastoid pneumatisation and facial canal dehiscence were evaluated. Facial canal dehiscence was measured if it was found to be present.Results This study showed that facial canal dimensions decreased in pneumatised mastoids. Facial canal dimensions in females were smaller than in males. Facial canal dehiscence was detected in 5.9 per cent and 6.5 per cent of the patients on the right and left sides, respectively. No correlations were found between facial canal dehiscence and mastoid pneumatisation. The length of dehiscence was 1.92 ± 0.44 mm (range, 0.86-2.51 mm) on the left side. In older subjects, left facial canal dehiscence was detected more, and the length of the dehiscence increased.Conclusion This study concluded that during surgery, facial canal dehiscence should be kept in mind in order to avoid complications. © 2019 JLO (1984) Limited.
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    The presence of Clival foramen through Multidetector computed tomography of the skull base
    (Lippincott Williams and Wilkins, 2015) Inal M.; Muluk N.B.; Ozveren M.F.; Celebi U.O.; Simsek G.; Burulday V.; Bilgili M.Y.K.
    Objectives: Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. Materials and Methods: One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging). The images were evaluated as clival foramen ''present'' or ''absent.'' Results: In our 186 patients, evaluation of MDCT showed that clival foramenwas absent in 66.7% (n=124) of patients. Only 33.3% (n=62) of patients had a clival foramen. In 3-D images, clival canal and clival foramen were shown more clearly compared with the MDCT. Conclusions: Knowledge of the clival canal might be useful in patients of questionable clival fracture or during neurosurgical operations in this region. During life the canal contained a vein connecting the basilar plexus with the venous plexus of the vertebral canal, and inferior petrosal sinuses. Before the surgical interventions in the clival region, the presence of the clival canal and foramen should also be known due to its vascular contents. By multidetector computed tomography and 3-D images, clival canal and foramen may be viewed preoperatively. Copyright © 2015 by Mutaz B. Habal, MD.