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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: iain.mckay-davies@nhs.net
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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

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