KHẢO SÁT MỐI LIÊN QUAN GIỮA TÌNH TRẠNG BỘC LỘ THẦN KINH MẶT VÀ VỊ TRÍ CHOLESTEATOMA TRONG PHẪU THUẬT Ở BỆNH NHÂN VIÊM TAI GIỮA MẠN TÍNH CHOLESTEATOMA

Abstract

Objective: To examine the association between tympanic‐segment facial nerve dehiscence (FND) and cholesteatoma location classified by STAM in patients undergoing surgery for chronic otitis media with cholesteatoma. Methods: Cross-sectional study of 106 ears with chronic otitis media with cholesteatoma operated at Ho Chi Minh City Ear–Nose–Throat Hospital (08/2024–08/2025). Results: Mean age was 43.3 years (range 16–82). Overall, FND was identified in 43,4% of ears. FND was significantly more frequent with multicompartment involvement of the tympanic cavity–attic–mastoid (TAM) (66,7% vs 24,1%; PR=2,76; p<0,001) and when cholesteatoma was present at S2 (sinus tympani; facial recess) (61,2% vs 28,1%; PR=2,20; p<0,001). Involvement of all STAM subsites was also associated with higher FND (68,2% vs 36,9%; PR=1,85; p=0,008). Patients with EAONO/JOS stage III had a higher FND rate than stage I–II (75% vs 37,8%; PR=1,99; p=0,006). Conclusion: Tympanic-segment FND is common during cholesteatoma surgery. The prevalence of this condition significantly increases in patients with cholesteatoma located at TAM, S2, as well as in patients with Stage III disease according to the EAONO/JOS classification. Recognizing these risk markers supports proactive endoscopic inspection, tailored surgical exposure, and facial-nerve protection to reduce iatrogenic injury.