RESUMEN
Eustachian tube (ET) dysfunction is one of the most important factors in the etiology of middle ear disease. There are several methods to assess the functions of ET which show the anatomic patency of the tube. However, functional patency of ET should be evaluated as well. For this reason, we used a scintigraphic method at 42 patients who had otitis media with effusion (study group) and traumatic perforation of the ear drum (control group) at 32 and 10 of them, respectively. After instillation of 100 microCi (100 microliters) Technetium 99m-macro-aggregated albumin (Tc99m-MAA) into the middle ear, 60 images were taken at 15 second intervals. Both groups were investigated as to whether there was radioactivity passage through ET and, the arrival time of the radioactivity to ET and to nasopharynx were calculated if the passage occurred. Radioactivity passage rates in the study and control groups were 5 (16%) and 10 (100%), respectively. The difference between both groups was statistically very significant (Chi-square, p < 0.001). Scintigraphy is a feasible tool for the assessment of ET functions. Scintigraphic methods should be improved and be used as a tubal function test in the future.
Asunto(s)
Trompa Auditiva/diagnóstico por imagen , Trompa Auditiva/fisiología , Otitis Media con Derrame/fisiopatología , Adolescente , Niño , Preescolar , Diagnóstico Diferencial , Trompa Auditiva/fisiopatología , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Otitis Media con Derrame/diagnóstico por imagen , Cintigrafía , Radiofármacos , Agregado de Albúmina Marcado con Tecnecio Tc 99m , Membrana Timpánica/lesionesRESUMEN
Fracture of the temporal bone is usually associated with skull injury and the patient is initially seen in the emergency room. As a result the diagnosis of facial paralysis may be delayed. The aim of this study is to emphasize the importance of early diagnosis and treatment of facial paralysis in such cases. Between 1990 and 1996, sixteen patients with facial paralysis due to temporal bone fracture were operated on within one month of trauma. The surgical technique was selected on the basis of the location of fallopian canal involvement and the patients hearing status. Six patients had grade VI, 7 had grade V and 3 had grade IV facial weakness preoperatively. Twelve patients had serviceable hearing. 9 of them underwent facial decompression through the transmastoid approach and 3 were operated on via the middle fossa approach. Four patients with unserviceable hearing had the operation through the translabyrinthine route. Postoperatively, 15 out of sixteen patients gained normal facial function while one had grade III facial weakness. Severe grade and sudden onset facial paralysis after temporal bone fracture should be surgically corrected as early as possible. The site of involvement of the facial canal and patient's hearing status should be considered in deciding the type of surgery to be applied.