Occurrence of Foramen of Huschke and Its Clinical Significance

 

Keerthana B, Mrs. M.S. Thenmozhi

Saveetha Dental College and Hospital, Poonamallee High Road, Chennai – 600 077

 

ABSTRACT:

Aim: To find the occurrence and clinical importance of foramen of Huschke. Background: The foramen tympanium, also known as foramen of Huschke is an anatomical variation in the external acoustic Meatus in the tympanic plate of the temporal bone where a bony defect connects the external acoustic Meatus to the temperomandibular joint. It's a defect in the normal ossification in the first five years of life . Reason : Our body is highly unique with various abnormal features . One such feature that drew interest was the foramen of Huschke. This triggered to investigate about that foramen and its clinical importance. The occurrence of this foramen may result in various complications

 

 

 

INTRODUCTION:

Foramen of Huschke, also called as foramen tympanicum is an abnormal foramen which was found by Emil Huschke. It's present during post natal development until the age of five.[1,3]  The foramen develops at birth during the formation and development of tympanic bone. It's present in the tympanic part of the temporal bone, on the inferior wall of the external acoustic meatus. In some cases, it is present at the apex of squamotympanic and petrotympanic fissures. The foramen gradually closes during the five years of age. In the absence of its closure, it might lead to several abnormalities of the external acoustic meatus and the structures surrounding it.

 

DEVELOPMENT:

The development of the tympanic bone from the tympanic ring leads to the formation of a ring shaped structure on the upper portion after birth. The tympanic bone fuses with the petrous part of the temporal bone through circular ossification which leads to the formation of the outer wall of the tympanic cavity. It then leads to the development of two tubercles which fuse with one another during the first year of life . This leads to an opening in the temporal bone which is called as the foramen of Huschke.[1,2]

 

MATERIALS AND METHODS:

A study was made on 60 skulls in Saveetha Dental College by carefully analysing the temporal bone for the absence or presence of the foramen. Also the variation in the size of the foramen was studied and the occurrence of the same in both  sides of the skull .

 

Fig 1: Bilateral Foramen

 

Fig 2: Unilateral Foramina

 

RESULTS:

The foramen of Huschke was  present in 14 (23.33%) and absent in 46 (76.66%) out of the 60 skulls that were studied.

Table 1: Presence of Unilateral and Bilateral Foramen in the Skulls

Foramen	Present	Absent
Presence	14 (23.33%)	46 (76.66%)
Sides present	Left- 7 (53.84%)	Right- 6 (42.85%)
Bilateral foramen	Left	Right
Presence	2	1

 

DISCUSSION:

According to the researches already made on the persistency of foramen of Huschke, it has been noted that the occurrence has been low but varying. In a total of 100 skulls studied on Indian skulls by Herzog and Fiese , evaluated a total of 16% whose sex was not mentioned. [8] In a another study by Ars, there was only a 0.7% persistency in 300 skulls that were examined.[1] Some authors have used various other methods such as X-Ray and CT to identify the foramen. [5,7] The foramen was not detected in X-Ray as the structures of the temporal bone was overlapping the foramen which made it difficult. [9] Also, various authors have used the CT to study for the same. Wang et al has found that there was an unilateral foramen in 3.4% of 13 skulls and Henrique had a persistency of 17 in 113 skulls.[6,1] These results are similar with that of the present study conducted. In one skull, there was the presence of bilateral foramen with 2 foramina on the left side and 1 on the right.

 

CONCLUSION:

It was found that the persistence of the foramen was very less which was about 23.33%.  Also, the foramen had a variable size. In some skulls, the foramen was present only in one side and was absent in the other. The presence of the foramen in later stages may result in various abnormalities in the ear and surrounding region which further leads to complications.

 

REFERENCES:

1.     Ars B. Le foramen de Huschke. Acta Otorhinolaryngol Belg 1988; 42:654–658.    

2.     Henrique Nogueira Reis; Antonio Carlos Pires Carvalho; Horácio Faig Leite; Rossana Corbo Ramalho de Mello; Sergio Salles Xavier- Persistent foramen of huschke: a tomographic study. Radiol Bras vol.39 no.4 São Paulo July/Aug. 2006

3.     Lacout A1, Marsot-Dupuch K, Smoker WR, Lasjaunias P.- Foramen tympanicum, or foramen of Huschke: pathologic cases and anatomic CT study. 2005 Jun-Jul;26(6):1317-23.

4.     Faig-Leite H, Horta Júnior JAC. Persistence of the foramen of Huschke. Dent Res 1999; 77:1177.       

5.     Dingle AF. Fistula between the external auditory canal and the temporomandibular joint: a rare complication of otitis externa. J Laryngol Otol 1992; 106:994–995.      

6.     Thomson HG. Septic arthritis of the temporomandibular joint complicating otitis externa. J Laryngol Otol 1989;103:319–321. 

7.     Wang RR, Bingham B, Hawke M, Kwok P, Li JG. Persistence of the foramen of Huschke in the adult: an osteological study. J Otolaryngol 1991; 20:251–253.

8.     Heffez L, Anderson D, Mafee M. Developmental defects of the tympanic plate: case reports and review of the literature. J Oral Maxillofac Surg 1989;47:1336–1340.     

9.     Herzog S, Fiese R. Persistent foramen of Huschke: possible risk factor for otologic complications after arthroscopy of the temporomandibular joint. Oral Surg Oral Med Oral Pathol 1989; 68:267–270.

10.  Hawke M, Kwok P, Mehta M, Wang RG. Bilateral spontaneous temporomandibular joint herniation into the external auditory canal. J Otolaryngol 1987;16:387–389.

 

 

Accepted on 14.06.2016        © RJPT All right reserved

Research J. Pharm. and Tech 2016; 9(11): 1835-1836