title: The surgical challenge of carotid artery and Fallopian canal dehiscence in chronic ear disease: a pitfall for endoscopic approach.
abstract: OBJECTIVE
  Endoscopic procedures are becoming common in middle ear surgery. Inflammation due to chronic ear disease can cause bony erosion of the carotid artery and Fallopian canals, making them more vulnerable during surgery. The objective of this study was to determine whether or not chronic ear disease increases dehiscence of the carotid artery and Fallopian canals.
  
  
  METHODS
  Comparative human temporal bone study.
  
  
  METHODS
  Otopathology laboratory.
  
  
  METHODS
  We selected 78 temporal bones from 55 deceased donors with chronic otitis media or cholesteatoma and then compared those two groups with a control group of 27 temporal bones from 19 deceased donors with no middle ear disease.
  
  
  METHODS
  We analysed the middle ear, carotid artery canal and Fallopian canal, looking for signs of dehiscence of its bony coverage, using light microscopy.
  
  
  RESULTS
  We found an increased incidence in dehiscence of the carotid artery and Fallopian canals in temporal bones with chronic middle ear disease. The size of the carotid artery canal dehiscence was larger in the middle ear-diseased groups, and its bony coverage, when present, was also thinner compared to the control group. Dehiscence of the carotid artery canal was more frequently located closer to the promontory. The incidence of Fallopian canal dehiscence was significantly higher in temporal bones from donors older than 18 years with chronic middle ear disease.
  
  
  CONCLUSIONS
  The increased incidence of the carotid artery and Fallopian canal dehiscence in temporal bones with chronic middle ear disease elevates the risk of adverse events during middle ear surgery.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.|Department of Otolaryngology, Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: H F
authors.initials: HF
authors.lastname: Pauna
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.|Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital (BOS), Sorocaba, São Paulo, Brazil.
authors.forename: R C
authors.initials: RC
authors.lastname: Monsanto
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Schachern
authors.affiliation: Department of Ophthalmology and Otolaryngology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul (UFRGS), Brazil.
authors.forename: S S
authors.initials: SS
authors.lastname: Costa
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
authors.forename: G
authors.initials: G
authors.lastname: Kwon
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.|Paparella Ear, Head and Neck Institute, Minneapolis, MN, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Paparella
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Cureoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001847:Bone Diseases / Q000473:pathology* / Q000601:surgery; D002102:Cadaver; D002339:Carotid Arteries / Q000473:pathology*; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000473:pathology* / Q000601:surgery; D013701:Temporal Bone / Q000473:pathology*