The importance of petrous apex and peri-carotid pneumatisation in subtotal petrosectomy and blind sac closure: a radiological study

2018 ◽  
Vol 132 (8) ◽  
pp. 698-702 ◽  
Author(s):  
I McKay-Davies ◽  
K Selvarajah ◽  
M Neeff ◽  
H Sillars
Keyword(s):  
Carotid Artery ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Petrous Apex ◽  
Tertiary Referral Centre ◽  
Subtotal Petrosectomy ◽  
Blind Sac Closure ◽  
Temporal Bones ◽  
Communication Pathway

AbstractObjectiveTo ascertain in what proportion the vertical segment of the intratemporal carotid artery on its medial aspect anatomically separates the peri-tubal cells and Eustachian tube from the remainder of the pneumatised spaces of the temporal bone.MethodA retrospective review was conducted of 222 adult and 29 paediatric consecutive computed tomography scans of petrous temporal bones from a single tertiary referral centre.ResultsIn 96 per cent of temporal bones, the carotid artery formed a lateral barrier (with no communication pathway medially) between air spaces anterior and posterior to it. This equated to 94 per cent when chronic otitis media cases were excluded.ConclusionThe degree of separation of middle-ear air cells from the Eustachian tube or nasopharynx, and the relevant anatomy, are reviewed. This knowledge helps to optimise the outcome of subtotal petrosectomy and blind sac closure. The frequency and process of pneumatisation of the petrous apex, and its connections with the middle ear, have been radiologically confirmed.

scholarly journals Comparative study between throat swab and ear discharge swabs culture and sensitivity findings in pediatric patients with bilateral chronic otitis media

2019 ◽  
Vol 5 (4) ◽  
pp. 932
Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P.
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Throat Swab ◽  
Chronic Otitis Media ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
The Common ◽  
Culture And Sensitivity

<p class="abstract"><strong>Background:</strong> Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.</p><p class="abstract"><strong>Methods:</strong> Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was <em>S. Aureus</em> followed by <em>Psuedomonas</em>. The ear swab and throat swab findings showed positive relationship (p&lt;0.05) for the common organisms i.e., <em>S. Aureus</em>, <em>pseudomonas</em> and <em>Streptococcus pyogenes</em> respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.</p><p class="abstract"><strong>Conclusions:</strong> The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.</p><p> </p>

Narrowest (ISTHMUS) Portion of Eustachian Tube: A Computer-Aided Three-Dimensional Reconstruction and Measurement Study

1997 ◽  
Vol 106 (7) ◽  
pp. 583-588 ◽  
Author(s):  
Masaharu Sudo ◽  
Isamu Sando ◽  
Akihiro Ikui ◽  
Chiaki Suzuki
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Three Dimensional ◽  
Three Dimensional Reconstruction ◽  
Cross Sectional ◽  
Computer Aided ◽  
Dimensional Reconstruction ◽  
Tensor Veli Palatini Muscle ◽  
Normal Human ◽  
Temporal Bones

Nine normal human temporal bones from persons 16 to 88 years old were studied by computer aided three-dimensional reconstruction and measurement. The length of the eustachian tube (ET) lumen in three portions (from pharyngeal orifice to tympanic orifice: cartilaginous, junctional, and bony) averaged 23.6 ±4.3 mm, 3.0 ± 1.9 mm, and 6.4 ± 2.6 mm. The narrowest portion of the ET lumen was in the cartilaginous portion in all cases: 20.5 ± 4.2 mm from the pharyngeal orifice and 3.1 ± 1.6 mm from the pharyngeal margin of the junctional portion. The cross-sectional area of the narrowest portion was 0.65 ± 0.2 mm2. The tendon of the tensor veli palatini muscle (TVPM) inserted into the lateral lamina in the narrowest portion of the ET lumen in five of nine cases. These results suggest that contraction of the TVPM opens the narrowest portion of the ET lumen to ventilate the middle ear and that this portion also plays a role in protecting the middle ear.

Role of Ige-Mediated Hypersensitivity in Otitis Media with Effusion: Pathophysiologic Considerations

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 15-19 ◽  
Author(s):  
Joel M. Bernstein ◽  
William J. Doyle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Accessory Cell ◽  
Middle Ear Mucosa ◽  
Mucus Production ◽  
Mediators Of Inflammation ◽  
Ige Mediated

A pathophysiologic model of otitis media with effusion secondary to IgE-mediated hypersensitivity is described. Specific mediators of inflammation are released by mucosal mast cells in the nasal mucosa following the interaction of antigen and specific IgE antibody. These mediators increase vascular permeability, mucosal blood flow, and, most important, mucus production. Furthermore, accessory cell types are recruited by colony-stimulating factors that in turn provide an autocrine-positive feedback for the influx of further inflammatory cells. The eustachian tube is then effectively obstructed by both intrinsic venous engorgement and extrinsic mucus plugs, isolating the middle ear space from the ambient environment The net result is the increased exchange of nitrogen into the middle ear mucosa from the middle ear cavity. This causes the development of a significant middle ear underpressure that disrupts tight junctions and allows for transudation of fluids into the middle ear space. The prolonged obstruction of the eustachian tube with mucus results in middle ear inflammation, mucosal metaplasia, and increased glandular activities, all of which are hallmarks of chronic otitis media with effusion.

Eustachian Tube Ventilatory Function in Children

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 171-177 ◽  
Author(s):  
Erdem I. Cantekin ◽  
Charles D. Bluestone ◽  
Leon P. Parkin
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Response Characteristic ◽  
Ventilatory Function ◽  
Stimulus Response ◽  
Tympanostomy Tubes ◽  
History Of ◽  
Middle Ear Disease

In order to establish a simple stimulus-response characteristic of Eustachian tube physiology in children, the tubal ventilatory function was studied. The parameters of active and passive opening of the tube were measured for three groups of patients with non-intact tympanic membranes. The group with traumatic perforations of the tympanic membrane without any history of middle ear disease had better active equilibration function than the group with chronic otitis media and perforations of the tympanic membrane and the group with tympanostomy tubes in the tympanic membrane. Quantitatively, this could be expressed in terms of residual positive pressures. In the study of repeated inflation of the middle ear, all groups had lower second opening pressures which are attributed to the effect of surface forces.

Eustachian Tube Lumen: Comparison between Normal and Inflamed Specimens

1989 ◽  
Vol 98 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Jacob Sadé ◽  
Michal Luntz
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Sectional Area ◽  
Secretory Otitis Media ◽  
Cross Sectional ◽  
Tube Lumen ◽  
Luminal Area ◽  
The Mean ◽  
Temporal Bones

This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube.

scholarly journals Multiple Osteomas in Middle Ear

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Yongxin Li ◽  
Qiuhuan Li ◽  
Shusheng Gong ◽  
Honggang Liu ◽  
Zilong Yu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Semicircular Canal ◽  
Chronic Otitis Media ◽  
Lateral Semicircular Canal ◽  
Type Iii ◽  
One Stage ◽  
Tensor Tympani Muscle

Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009), and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage.

Mucous Glands in the Middle Ear and Osseous Eustachian Tube

1973 ◽  
Vol 82 (1) ◽  
pp. 80-88 ◽  
Author(s):  
K. Bak-Pedersen ◽  
M. Tos
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Normal Component ◽  
Great Majority ◽  
Oval Window ◽  
Mastoid Process ◽  
Middle Ear Mucosa ◽  
Clinically Normal ◽  
The Individual ◽  
Temporal Bones

The mucous membranes from the osseous Eustachian tube, tympanic cavity, epitympanum, antrum, and mastoid process on clinically normal middle ears from 45 temporal bones were stained by the PAS-alcian blue whole-mount method and systematically studied for the presence, number, and density of mucous glands. Only four patients did not exhibit glands. The total number of glands in the individual patients amounted to less than 60 in 85% of the cases. Only two patients showed high counts, 273 and 337 glands, respectively. The mean density was 0.53 gland per mm2. In most of the patients the glands were found in three to six different localities, the most common locality being the oval window. Glands were found in only ten osseous Eustachian tubes, in very small numbers. By far the great majority of glands were inactive and degenerated. In ten patients, however, there was a small number of active glands. The glands demonstrated are presumably the sequelae of previous pathological actions upon the middle ear and Eustachian tube, and the glands are probably not a normal component of the middle ear mucosa.

Goblet Cell Population in the Pathological Middle Ear and Eustachian Tube of Children and Adults

1977 ◽  
Vol 86 (2) ◽  
pp. 209-218 ◽  
Author(s):  
Mirko Tos ◽  
K. Bak-Pedersen
Keyword(s):  
Cell Density ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Goblet Cell ◽  
Newborn Infants ◽  
Goblet Cells ◽  
Secretory Otitis Media ◽  
Temporal Bones ◽  
Different Parts ◽  
Goblet Cell Density

On 64 temporal bones from slightly abnormal and pathological prematures and newborn infants, children, and adults, 35,000–40,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. The goblet cells were present in all Eustachian tubes and middle ear areas. In ears previously exposed to infection the density was slightly increased in the tubal orifice and in most parts of the middle ear. In subacute and acute pathological actions, especially tubal occlusion, and in chronic diseases, such as active chronic otitis and in secretory otitis media, the goblet-cell density is appreciably increased.

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