Fatihoglu, Erdem; Aydin, Sonay; Karavas, Erdal; Kantarci, Mecit

Introduction and objectives: The wide range of variability of SS pneumatization and relation with surrounding structures can result in serious complications; seeing that, the assessment of regional anatomy is essential for both surgeons and radiologists. We mainly aim to reveal the possible correlation between the SS pneumatization types and protrusion/dehiscence of the adjacent neurovascular structures in a larger population by using computerized tomography (CT) images. Methods: The type of SS pneumatization (I–IV), pneumatization of anterior clinoid process (ACP), greater wing of sphenoid (GWS), and pterygoid process (PP) was evaluated. Protrusion and dehiscence of ICA, ON, MN, and VN was noted. Results: 1003 patients were included into the study. ICA, ON, and MN protrusions were not seen in patients with the type I or II SS on both sides. These protrusions were most frequently seen along with the type IV SS on both sides (p < 0.05). ICA, ON, MN, and VN dehiscence was not found in any patients with the type I SS. The rate of ICA protrusion increased with presence of GWS and PP; ICA dehiscence was found to be positively correlated with ACP, GWS, and PP pneumatization. Conclusions: Variations, either amount or the extent, of the pneumatization of the SS are related with the presence of protrusion/dehiscence of ICA, ON, MN and VN. Knowing and reporting these relations can decrease the rate of complications during skull base surgery.

Simsek, Eda; Ozkan, Ozalkan; Kucur, Cüneyt; Carlıoglu, Ayşe

The purpose of this study was to assess closure rates in tympanic membrane perforations of various dimensions using the tragal cartilage-perichondrium composite graft and its effect on hearing values and also to present our own experiences. Materials and methods Sixty-one patients presenting to our clinic in 2014–2015 and diagnosed with tympanic membrane perforation were included in the study. Otomicroscopic and otoendoscopic examinations were performed preoperatively and at the 12th month postoperatively. Patients were divided into three groups depending on perforation diameter. Pure tone audiometry was performed at 500, 1000, 2000, and 4000 Hz (Hz) preoperatively and at the 12th month postoperatively, air-bone values were recorded, and air-bone gap (ABG) was calculated. Surgery was performed under local anesthesia usıng the transcanal, push-through (transperforation) technique. Perichondrium supported by thinned cartilage graft obtained from the tragal cartilage was used for tympanic membrane repair. Results Graft acceptance levels after 12 months in small, medium, and large perforations were 100%, 93.5%, and 93.75%, respectively, and 95% on average. Preoperative air-bone gap values were 18.64 ± 9.63 decibel (dB), 22.51 ± 9.66 dB, and 28.43 ± 11.36 dB, respectively, and 23.18 ± 11.36 dB on average, while 12th month postoperative air-bone gap values were 9.14 ± 8.27 dB, 11.25 ± 6.73 dB, and 17.37 ± 9.22 dB, respectively, and 12.37 ± 8.28 dB on average. The difference between pre- and postoperative 12th month air-bone gap values was statistically significant (p < 0.005). Conclusion The use of thinned cartilage-supported perichondrial grafts in patients with all sizes of tympanic membrane perforation is safe and effective in terms of both anatomical healing and restoration of hearing and can represent a first-choice technique that is easy to perform and involves minimal morbidity.