Surgical Treatment of Extensive Ossification over the Lateral
Semicircular Canal in Otitis Media Surgery
Abstract
Introduction: Extensive ossification over the semicircular canal is not
common in the surgery of otitis media. This study aimed to reduce
intraoperative and postoperative complications among patients with
extensive ossification over the lateral semicircular canal and
concomitant otitis media. Methods: The patients’ clinical data were
retrospectively reviewed to determine the preoperative imaging
characteristics of perilabyrinthine ossificans and key points of
surgical operation. The data of 156 patients who underwent radical
mastoidectomy or tympanoplasty between January 2016 and December 2018
due to chronic otitis media or cholesteatoma were reviewed. Seven
patients with extensive ossification over the lateral semicircular canal
were identified, and their preoperative imaging results, intraoperative
procedures, and postoperative symptoms were evaluated. Results: The
incidence of extensive ossification over the lateral semicircular canal
among patients with chronic otitis media was 4.5% (7/156). Ossification
occurred in the periphery of the lateral semicircular canal; the osseous
tissue frequently fused with the osseous lateral semicircular canal,
obscuring the boundaries between the two structures. A semicircular
canal fistula was observed in two of the seven patients with extensive
ossification over the lateral semicircular canal. The two patients
underwent surgical patching or filling and symptomatic hormone
treatment. Postoperative vertigo occurred in both patients and subsided
within 1–3 months. There was no significant difference between
preoperative and postoperative hearing thresholds. Conclusion: Extensive
ossification over the lateral semicircular canal has a low incidence and
may be discovered through preoperative imaging evaluation, enabling
medical personnel to engage in adequate preoperative preparations.
During the surgical procedure, navigational landmarks are required to
determine the anatomical structures. The management of semicircular
canal fistulas is essential to the reduction of intraoperative and
postoperative complications.