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The importance of petrous apex and peri-carotid pneumatisation in subtotal petrosectomy and blind sac closure: a radiological study

Published online by Cambridge University Press:  23 July 2018

I McKay-Davies ,
K Selvarajah ,
M Neeff  and
H Sillars
I McKay-Davies*
Affiliation:
ENT Department, Maidstone and Tunbridge Wells NHS Trust, UK
K Selvarajah
Affiliation:
Department of ORL, Auckland City Hospital, New Zealand
M Neeff
Affiliation:
Department of ORL, Auckland City Hospital, New Zealand
H Sillars
Affiliation:
Department of ORL, Auckland City Hospital, New Zealand
*
Author for correspondence: Mr Iain McKay-Davies, ENT Department, Maidstone Hospital, Hermitage Lane, Maidstone ME16 9QQ, UK E-mail: [email protected]
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Abstract

Objective

To ascertain in what proportion the vertical segment of the intratemporal carotid artery on its medial aspect anatomically separates the peri-tubal cells and Eustachian tube from the remainder of the pneumatised spaces of the temporal bone.

Method

A retrospective review was conducted of 222 adult and 29 paediatric consecutive computed tomography scans of petrous temporal bones from a single tertiary referral centre.

Results

In 96 per cent of temporal bones, the carotid artery formed a lateral barrier (with no communication pathway medially) between air spaces anterior and posterior to it. This equated to 94 per cent when chronic otitis media cases were excluded.

Conclusion

The degree of separation of middle-ear air cells from the Eustachian tube or nasopharynx, and the relevant anatomy, are reviewed. This knowledge helps to optimise the outcome of subtotal petrosectomy and blind sac closure. The frequency and process of pneumatisation of the petrous apex, and its connections with the middle ear, have been radiologically confirmed.

Keywords

Petrous BoneTomographyX-Ray ComputedMastoid
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 8 , August 2018 , pp. 698 - 702
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr I McKay-Davies takes responsibility for the integrity of the content of the paper

References

1Lindsay, JR. Petrous pyramid of temporal bone: pneumatization and roentgenologic appearance. Arch Otolaryngol 1940;31:231–5Google Scholar
2Gleeson, MJ, ed. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery, 7th edn. Boca Raton: CRC Press, 2008Google Scholar
3Virapongse, C, Sarwar, M, Bhimani, S, Sasaki, C, Shapiro, R. Computed tomography of temporal bone pneumatization: 1. Normal pattern and morphology. AJR Am J Roentgenol 1985;145:473–81Google Scholar
4Jen, A, Sanelli, PC, Banthia, F, Victor, JD, Selesnick, SH. Relationship of petrous temporal bone pneumatiztion to the eustachian tube lumen. Laryngoscope 2004;114:656–60Google Scholar
5Saim, L, McKenna, MJ, Nadol, JB. Tubal and tympanic openings of the peritubal cells: implications for cerebrospinal fluid otorhinorrhea. Am J Otol 1996;17:335–9Google Scholar
6Lindsay, JR. Suppuration of the petrous apex. Ann Otol Rhinol Laryngol 1938;47:3–36Google Scholar
7Roland, PS, Meyerhoff, WL, Judge, LO, Mickey, BE. Asymmetric pneumatization of the petrous apex. Otolaryngol Head Neck Surg 1990;103:80–8Google Scholar
8Grant, IL, Welling, DB, Oehler, MC, Baujan, MA. Transcochlear repair of persistent cerebrospinal fluid leaks. Laryngoscope 1999;109:1392–6Google Scholar
9Hentona, H, Ohkubo, J, Tsutsumi, T, Tanaka, H, Komatsuzaki, A. Pneumatization of the petrous apex [in Japanese]. Nihon Jibiinkoka Gakkai Kaiho 1994;97:450–6Google Scholar
10Hindi, K, Alazzawi, S, Raman, R, Prepageran, N, Rahmat, K. Pneumatization of mastoid air cells, temporal bone, ethmoid and sphenoid sinuses. Any correlation? Indian J Otolaryngol Head Neck Surg 2014;66:429–36Google Scholar
11McRackan, TR, Brackman, DE. Otology, Neurotology and Skull Base Surgery: Clinical Reference Guide. San Diego: Plural Publishing, 2016Google Scholar
12Anson, BJ, Wilson, G, Gaardsmoe, JP. Air cells of petrous portion of temporal bone in a child four and a half years old. Arch Otolaryngol 1938;27:588–605Google Scholar