title: Variant petrotympanic fissure as possible cause of an otologic complication during TMJ arthroscopy. A case report.
abstract: In this reported case, a variant petrotympanic fissure--opening at the height of the orifice of the Eustachian tube into the hypotympanon--was identified by high resolution computed tomography (CT) as the possible cause of a tympanic membrane perforation. Inner ear function was preserved by an otosclerotic stapes which prevented destruction of the labyrinth. The perforation was closed by a myringoplasty and was to be followed by a stapedectomy after six months to restore normal hearing. Surgeons performing temporomandibular joint arthroscopy should be aware that in a small percentage of patients a variant anatomy of the tympanic plate exists and, therefore, great care must be exercised in the manipulation of instruments near this structure. A preoperative high resolution CT with thin slices of the temporal bone might allow identification of these high risk patients.
authors.affiliation: Department of Otorhinolaryngology, University of Vienna, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Schickinger
authors.forename: W
authors.initials: W
authors.lastname: Gstoettner
authors.forename: C
authors.initials: C
authors.lastname: Cerny
authors.forename: J
authors.initials: J
authors.lastname: Kornfehl
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects*; D004432:Ear, Middle / Q000033:anatomy & histology*; D005064:Eustachian Tube / Q000033:anatomy & histology; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000601:surgery; D006801:Humans; D009225:Myringoplasty; D010040:Otosclerosis / Q000150:complications* / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis*; D018058:Tympanic Membrane Perforation / Q000209:etiology*