Comparative study through TC of the tympanosquamous suture in cases of attical cholesteatoma vs healthy ears.
OBJECTIVE
When performing surgery on ears with cholesteatoma we observed a higher prominence of the anterior edge of the tympanosquamous suture (TSS). The aim was to find out whether these surgical findings corresponded to a particular morphology of the tympanosquamous suture (TSS) in cholesteatomas.


METHODS
A retrospective analysis was carried out using preoperative computed tomography (CT) of the TSS in patients undergoing surgery for cholesteatoma in the period between January 2006 and December 2008. Patients older than 18 years were included, who had not been previously operated, with a CT performed at the hospital and with a histology which proved cholesteatoma (n=31). The findings of the TSS from these 31 cases were compared with those of 30 healthy ears. The healthy group included 20 cases of unilateral cholesteatoma (20 healthy/31 cholesteatomas) and a control group of 10 healthy patients studied for cochlear implants (n=10). Measurements of the distance in mm. were made selecting two points A and B of the TSS (A being the furthest point and B the nearest to the edge of the suture). The CT cuts were selected according to the greatest and smallest separation of the TSS.


RESULTS
Comparing the maximum and minimum distance of the TSS in points A and B of all the ears, according to pathological state (heathly ears vs cholesteatoma ears), we detected a reduced minimal distance in A (p=0.036) and B (p=0.014) in the healthy ears with respect to the cholesteatoma ears. No statistically significant differences were found in maximum distances A and B (p>0.05).


CONCLUSIONS
This study provides objective data on a lesser closure of the TSS in cases of cholesteatoma vs healthy ears. We correlate this finding with the aetiopathogenesis of attic cholesteatoma.
Girons-Bonells
Josefina
J
Servicio de Otorrinolaringología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. josefinagirons@gmail.com
Fontes-Carame
Daniel
D
Fité-Gallego
Anna
A
Masuet-Aumatell
Cristina
C
Maños-Pujol
Manuel
M
D000328:Adult; D002508:Cephalometry / Q000379:methods*; D018424:Cholesteatoma, Middle Ear / Q000000981:diagnostic imaging*; D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D004432:Ear, Middle / Q000000981:diagnostic imaging; D006801:Humans; D012016:Reference Values; D012189:Retrospective Studies; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed