دورية أكاديمية
Why did we encounter gusher in a stapes surgery case? Was it enlarged medial aperture of the cochlear aqueduct?
| العنوان: | Why did we encounter gusher in a stapes surgery case? Was it enlarged medial aperture of the cochlear aqueduct? |
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| المؤلفون: | Satar B; Department of Otorhinolaryngology, Head and Neck Surgery, Gulhane Medical School, University of Health Sciences, 06018, Etlik, Ankara, Turkey. bulentsatar@yahoo.com., Genc H; Department of Otorhinolaryngology, Head and Neck Surgery, Gulhane Medical School, University of Health Sciences, 06018, Etlik, Ankara, Turkey., Meral SC; Department of Otorhinolaryngology, Head and Neck Surgery, Gulhane Medical School, University of Health Sciences, 06018, Etlik, Ankara, Turkey. |
| المصدر: | Surgical and radiologic anatomy : SRA [Surg Radiol Anat] 2021 Feb; Vol. 43 (2), pp. 225-229. Date of Electronic Publication: 2020 Oct 27. |
| نوع المنشور: | Case Reports; Journal Article; Video-Audio Media |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8608029 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1279-8517 (Electronic) Linking ISSN: 09301038 NLM ISO Abbreviation: Surg Radiol Anat Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin ; New York : Springer International, c1986- |
| مواضيع طبية MeSH: | Cerebrospinal Fluid Otorrhea/*etiology , Cochlear Aqueduct/*abnormalities , Intraoperative Complications/*etiology , Stapes Surgery/*adverse effects, Cerebrospinal Fluid Otorrhea/diagnosis ; Cochlear Aqueduct/diagnostic imaging ; Cochlear Aqueduct/injuries ; Humans ; Intraoperative Complications/diagnosis ; Male ; Preoperative Period ; Tomography, X-Ray Computed ; Young Adult |
| مستخلص: | Background and Purpose: Preoperative prediction of cerebrospinal fluid (CSF) gusher is important for stapes surgery. According to the current opinion settled among otologists and radiologists, the issues of whether enlarged cochlear aqueduct might be a cause of CSF gusher in stapes surgery and which segment of the aqueduct should be taken into account to diagnose enlarged cochlear aqueduct in computerized tomography (CT) are controversial. The case we encountered led us to hypothesize that enlarged cochlear aqueduct might cause CSF gusher in stapes surgery and that shape and diameter of medial aperture of the cochlear aqueduct are important in this prediction. Methods and Results: Enlarged medial aperture of the cochlear aqueduct with a shape differed from that of the other side was retrospectively diagnosed in thin-slice CT in a patient who had been undergone middle ear and stapes surgery for conductive hearing loss. This finding went unnoticed in preoperative CT. In the small fenestra stapedotomy operation, CSF gusher occurred through opening in the ill-defined, fixed and thickened stapes footplate. A piece of temporalis fascia and reshaped incus were appropriately placed which stopped the gusher. Re-evaluation of preoperatively taken CT showed that anterior-posterior and superior-inferior diameters of the medial aperture were 11.7 mm and 2.87 mm in CSF gusher side versus 2.95 mm and 1.88 mm on the other side, respectively. Its shape in gusher side differed from that of the other side. Conclusion: This report is the first to show video-documented CSF gusher in a patient with enlarged medial aperture of the cochlear aqueduct. It appears to be plausible to propose that these findings have to change the otologists' and radiologists' perspective to the cochlear aqueduct. It can be deduced that difference in shapes of the medial aperture in both sides might be an indicator of potential CSF gusher. |
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| فهرسة مساهمة: | Keywords: Cerebrospinal fluid gusher; Medial aperture of cochlear aqueduct; Otosclerosis; Small fenestra stapedotomy; Stapes surgery |
| تواريخ الأحداث: | Date Created: 20201028 Date Completed: 20210809 Latest Revision: 20210809 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1007/s00276-020-02602-8 |
| PMID: | 33111218 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1279-8517 |
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| DOI: | 10.1007/s00276-020-02602-8 |