Clinical significance of the mastoid emissary vein in paediatric Osia implantation

Intraoperative bleeding directly attributable to injury of the MEV occurred in 3 of 52 cases (5.77%). Preoperative temporal bone CT was available in 28 cases (53.85%). Mean MEV diameter was significantly larger in bleeding compared to non-bleeding cases (5.17 ± 1.78 mm vs 1.41 ± 1.10 mm; P<i> = </i> .03), with a large effect size. There were few post-operative complications and excellent audiometric outcomes.The paucity of literature on the MEV's surgical relevance reflects the infrequent need for posterior mastoid region dissection in standard otologic procedures. This series is the first to demonstrate a direct link between MEV diameter and bleeding risk during paediatric Osia implantation. Routine preoperative assessment of the MEV may reduce avoidable surgical complications and enhance operative saftey.