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Subannular tube insertion: anatomical considerations

Published online by Cambridge University Press:  16 November 2015

A K Guidera ,
L Benoiton ,
L McManus  and
P J D Dawes
A K Guidera
Affiliation:
ORLHNS Department, Christchurch Public Hospital, New Zealand
L Benoiton
Affiliation:
Department of Plastic Surgery, Hutt Hospital, Wellington, New Zealand
L McManus
Affiliation:
Emergency Department, Middlemore Hospital, Auckland, New Zealand
P J D Dawes*
Affiliation:
Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
*
Address for correspondence: Assoc Prof P J D Dawes, ORLHNS Department, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand Fax: 00 64 3 474 7956 E-mail: patrick.dawes@southerndhb.govt.nz
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Abstract

Objectives:

To assess the distance between the bony groove created during subannular tubes placement and the chorda tympani, and examine the depth of the hypotympanum and retrotympanum.

Method:

Grooves drilled in cadaver temporal bones at two levels were imaged to measure: the distance between the chorda tympani nerve and the tympanic sulcus, and the depth of the hypotympanum and the retrotympanum relative to the annulus.

Results:

The chorda tympani was between 0 and 5 mm from the groove cut across the annulus. The hypotympanum average depth was 2 mm (0.44–6.40 mm) and the retrotympanum average depth was 1 mm (0–2.53 mm).

Conclusion:

Grooves drilled across the tympanic sulcus should be placed at a point 20 per cent of the height of the tympanic membrane or lower; this will ensure least risk of injury to the chorda tympani nerve. The depth of the hypotympanum and retrotympanum dictates that the posteroinferior part of a subannular tube flange should be approximately 2 × 1 mm.

Keywords

AnatomyChorda Tympani NerveOtitis MediaMiddle Ear Ventilation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 1 , January 2016 , pp. 69 - 75
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented at the 65th Annual and General Scientific Meeting of the New Zealand Society of Otolaryngology – Head and Neck Surgery, 31 October 2012–2 November 2012, Wellington, New Zealand, and at the Australian Society of Otolaryngology Head and Neck Surgery 2013 Annual Scientific Meeting, 16–20 March 2013, Perth, Australia.

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