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Middle ear ventilation status postoperatively after translabyrinthine resection of vestibular schwannoma with mastoid obliteration and Eustachian tube occlusion: is the Eustachian tube enough to…

Overview of attention for article published in Journal of Otolaryngology - Head & Neck Surgery, August 2016
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Title
Middle ear ventilation status postoperatively after translabyrinthine resection of vestibular schwannoma with mastoid obliteration and Eustachian tube occlusion: is the Eustachian tube enough to ventilate the middle ear without the mastoid air cell system?
Published in
Journal of Otolaryngology - Head & Neck Surgery, August 2016
DOI 10.1186/s40463-016-0157-z
Pubmed ID
Authors

James Belyea, Brandon Wickens, Manohar Bance

Abstract

Gas pressure balance is essential for maintaining normal middle ear function. The mucosal surfaces of the middle ear, the mastoid air cell system (MACS), and the Eustachian tube (ET) play a critical role in this process; however, the extent that each of these factors contributes to overall middle ear ventilation is unknown. The objective of this study was to determine if the ET alone can maintain normal middle ear pressure without the MACS. To do this, we reviewed subjects who had their MACS completely removed with translabyrinthine (TL) surgery for vestibular schwannoma. A retrospective chart review was done to collect pre and postoperative tympanometry data from patients who underwent resection of vestibular schwannoma. Data from the operative side was compared to the non-operative side at 2 years post-op. Twenty-four patients were included in this study. Of these, 63 % achieved a type A tympanogram at 2 years post-op in the TL resection group, implying an ability to maintain middle ear pressure in the absence of a mastoid cavity. Because some had negative pressures post TL resection, the average change in pre and postoperative pressure was -37.5 daPa for the operative side and 7.8 daPa for the non-operative side. This was significantly different. The difference for change in pre and postoperative pressure and compliance between operative and non-operative side might be expected from the ET plugging during TL resection. However, more interesting are those patients in whom the ET presumably reopens, and in these subjects, despite having no mastoid compartment at all, and the space obliterated with fat, they were still able to maintain normal ventilation of the middle ear space. Our findings imply that the ET alone is adequate to ventilate at least the reduced middle ear space following TL surgery in most subjects, and perhaps in 100 % if the ET hadn't been plugged during surgery. Hence, the mastoid air cell system, even when healthy, is not needed to maintain air in the middle year cleft.

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Mendeley readers

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Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 3 20%
Librarian 1 7%
Lecturer 1 7%
Other 1 7%
Student > Bachelor 1 7%
Other 1 7%
Unknown 7 47%
Readers by discipline Count As %
Medicine and Dentistry 6 40%
Social Sciences 1 7%
Chemistry 1 7%
Engineering 1 7%
Unknown 6 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 September 2016.
All research outputs
#22,830,981
of 25,457,858 outputs
Outputs from Journal of Otolaryngology - Head & Neck Surgery
#509
of 629 outputs
Outputs of similar age
#308,461
of 348,317 outputs
Outputs of similar age from Journal of Otolaryngology - Head & Neck Surgery
#4
of 7 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 629 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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