scholarly journals Evaluation of the Mastoid Emissary Canals with Computerized Tomography in Patients with Chronic Otitis Media

2019 ◽  
Vol 81 (01) ◽  
pp. 082-087
Author(s):  
Ozkan Ozen ◽  
Caner Sahin

Abstract Background The mastoid emissary veins (MEVs) pass through the mastoid emissary canal-mastoid foramen (MEC-MF) in the mastoid region of the skull. MEVs can give rise to complications during surgical procedures. The purpose of our study was to investigate the morphological and morphometric characteristics of MECs of patients with clinical chronic otitis media (COM) using high-resolution computed tomography (HRCT). Methods Patients diagnosed with COM and undergoing temporal HRCT were identified by retrospectively scanning our hospital's automation system. Patients undergoing temporal HRCT for reasons other than COM, infection or tinnitus were identified for the control group by scanning the PACS archive. Sixty-two mastoid regions were examined in 38 unilateral and 12 bilateral COM patients, and 100 mastoid regions in the 50 patients in the control group. The presence of an accessory MEC-MF and MEC-MF diameters was evaluated in both groups. Results Main MEC diameters on the side of the ear with COM were 1.6 mm, and total accessory and main MEC diameters were 1.8 mm, both values being significantly higher than in the control group. Presence of accessory MEC on the side of the ear with COM was determined at 61.8%, significantly higher than in the control group. Conclusion Preoperative awareness of cranial venous drainage abnormalities is important to reduce surgical complications. Our study shows that MECs may be wider in diameter in patients with COM. MECs in COM patients must be identified before surgery to the mastoid region.

2019 ◽  
Vol 99 (8) ◽  
pp. 532-536
Author(s):  
Yi-Fang Lee ◽  
Pei-Yin Wei ◽  
Chia-Huei Chu ◽  
Wen-Huei Liao ◽  
An-Suey Shiao ◽  
...  

Whether the dimension of the osseous external auditory canal (OEAC) is related to chronic otitis media (COM) remains an important but unresolved issue. In the literature, routine canaloplasty has been suggested to help elucidate this problem. In this study, we intended to investigate the relationship between the diameter or shape of OEAC and COM. We retrospectively reviewed the high-resolution computed tomography (HRCT) images of the temporal bones of 62 patients with unilateral COM who underwent tympanoplasty from January 1, 2011, to December 31, 2013. For comparison, the HRCT images of another 62 patients with normal ears were collected to be the control group. The shape of OEAC was categorized into 5 groups according to Mahboubi’s classification, and the dimension of each patient’s OEAC was measured at 2 defined sections (annular section and isthmus/midcanal section). The most prevalent shape of OEAC for the lesion sides of the ears was cylindrical, followed by conical, and hourglass in both the COM and the control groups. As to the dimension of OEAC, there were no significant differences between lesion ears and normal ears among patients in the COM group as well as between lesion ears in the COM group and normal ears in the control group. We concluded that the bony dimension of the external ear canal was not related to COM. This suggested that chronic inflammation or infection of middle ear may not cause bony thickening of OEAC, despite the kind of OEAC shape involved.


Author(s):  
P J Clamp ◽  
K De-Loyde ◽  
A R Maw ◽  
S Gregory ◽  
J Golding ◽  
...  

Abstract Objective This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. Method This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. Results Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. Conclusion The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.


2021 ◽  
Vol 10 (25) ◽  
pp. 1862-1865
Author(s):  
Sanjana Pradeep ◽  
Swaroop Dev ◽  
Jyothi Swarup Raju ◽  
Shravya Pasunuti

BACKGROUND Chronic otitis media (COM) of squamosal type is associated with cholestatoma with potential complications. Clinical examination and high resolution computed tomography (HRCT) scans are necessary to assess the disease site and extension. The purpose of the study was to compare the preoperative HRCT findings with the intraoperative surgical findings in squamosal type of chronic otitis media as well as various parameters in HRCT temporal bone and intraoperative findings. METHODS A prospective study was conducted on 30 patients aged between 18 and 60 years of both the genders who presented with chronic otitis media squamosal type, for a period of 22 months who attended the outpatient department of ENT. RESULTS HRCT findings and intraoperative findings were compared and results were analysed. Facial canal erosion (P - 0.0031), tegmen plate erosion (P - 0.0001), sigmoid sinus plate erosion (P - 0.002) were found to be statistically significant. Lateral semicircular canal fistula (P - 0.36) and ossicular status malleus (P - 1.000), incus (P - 0.949), stapes suprastructure (P - 0.984), and stapes footplate erosion (P - 0.977) were found to be statistically insignificant. CONCLUSIONS In our study, HRCT imaging for COM squamosal type, accurately depicted the soft tissue mass, erosion of tegmen plate, sigmoid sinus plate, scutum, lateral semicircular canal fistula, incus and suprastructure of stapes erosion and the same were found intraoperatively as well. Our study showed good comparison between the preoperative HRCT scans and the surgical findings in cholesteatoma cases. HRCT is confirmed to be valuable in the diagnosis and in guiding the surgical management of cholesteatoma. KEY WORDS Chronic Otitis Media, Cholesteatoma, HRCT Temporal Bone, Modified Radical Mastoidectomy


2018 ◽  
Vol 97 (8) ◽  
pp. E13-E18 ◽  
Author(s):  
Mary Daval ◽  
Hervé Picard ◽  
Emilie Bequignon ◽  
Philippe Bedbeder ◽  
André Coste ◽  
...  

The relationship between otitis media with effusion (OME) and chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. We conducted a cross-sectional study of 80 consecutively presenting patients—42 males and 38 females, aged 15 to 76 years (median: 48)—who were diagnosed with CRSwNP. Our aim was to ascertain the prevalence of OME in CRSwNP patients, to determine whether the severity of CRSwNP affected OME, and to identify risk factors for OME in CRSwNP patients. The severity of CRSwNP was assessed on the basis of nasal symptoms, endoscopic nasal examinations, and Lund-Mackay staging scores. In addition to demographic data, we obtained information on each patient's history of otitis, otoscopic findings, and the results of pure-tone audiometry and tympanometry. We then compared the data between CRSwNP patients with OME (n = 20) and those without (n = 60). In the OME group, a conductive hearing loss was present in 16 patients (80.0%); all patients in the control group had normal hearing. With regard to symptoms, only rhinorrhea appeared to be more common in patients with OME than in those without, although the difference was not statistically significant. We found no significant difference in nasal polyposis grades between the two groups. Also, we found no correlations between the risk of OME and previous surgical treatment, asthma, allergy, aspirin intolerance, aspirin and/or NSAID intolerance, aspirin and/or sulfite intolerance, and aspirin-exacerbated respiratory disease. Based on our findings, we conclude that OME occurs frequently during the evolution of CRSwNP, even when the nasal disease is well controlled. This finding suggests the possible presence, in OME and/or CRSwNP, of a global inflammatory process that involves the epithelium in both the middle ear and upper airway.


2020 ◽  
pp. 000348942094321
Author(s):  
Ameen Biadsee ◽  
Feda Fanadka ◽  
Or Dagan ◽  
Kassem Firas ◽  
Benny Nageris

Objective: To compare the size of Ostmann’s fat pad (OFP) between healthy ears and ears with chronic otitis media with cholestatoma (COMwC) using magnetic resonance imaging (MRI). Methods: Twenty-six patients with unilateral COMwC underwent mastoidectomy. Pre-operative MRI records were reviewed retrospectively. The healthy ears served as the control group. OFP is represented by the maximum diameter of the high intensity area medial to the tensor veli palatini muscle (TVP); M1. A reference diameter was defined from the medial border of OFP reaching the medial border of the medial pterygoid muscle; M2. Values of M1, M2 and the ratio of M1:M2 was compared between the healthy and pathological ear in each patient. Results: All 26 patients (16 females,10 males) had unilateral cholestatoma. Mean age was 37.6 years (range 19-83). In the healthy (H) ears group, mean M1H was 2.04 ± 0.53 mm, mean M2H was 9.57 ± 2.57 mm. In the pathological (P) ears group; mean M1P was 2.03 ± 0.55 mm, mean M2P was 9.86 ± 2.37 mm. A comparison of M1 and M2 values between the healthy and pathological ear groups was not statistically significant ( P = .853 and P = .509, respectively). Mean M1H:M2H ratio in the healthy ears group was 0.22 ± 0.05, mean M1P:M2P ratio in the pathological ear group was 0.21 ± 0.06. A comparison between these ratios found no significant statistical correlation ( P = .607). Conclusion: The size of Ostmann’s fat pad does not affect the development of chronic otitis media with cholestatoma in adults.


2014 ◽  
Vol 128 (1) ◽  
pp. 60-63 ◽  
Author(s):  
S Genc ◽  
M G Genc ◽  
I B Arslan ◽  
A Selcuk

AbstractAim:This study aimed to determine whether or not the middle cranial fossa dural plate is located lower (i.e. more caudally) in patients with chronic otitis media, relative to adjacent structures.Methods:The authors retrospectively investigated computed tomography temporal bone scans of 267 ears of 206 patients who had undergone surgery with a diagnosis of chronic otitis media, together with scans of 222 ears of 111 patients without chronic otitis media. The depth of the middle cranial fossa dural plates was recorded.Results:The mean depth of the middle cranial fossa dural plate was 4.59 mm in the study group and 2.71 mm in the control group (p < 0.001). The middle cranial fossa dural plate was located lower in the right ear in both the study and control groups.Conclusion:The middle cranial fossa dural plate was located lower in patients with chronic otitis media, and in the right ears of both patients and controls. Surgeons should take this low location into consideration, and take extra care, during relevant surgery on patients with chronic otitis media.


Author(s):  
Akanksha Dhiman ◽  
Ankur Gupta ◽  
Nishi Sharma ◽  
Akhilandeswari Prasad

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.</p><p class="abstract"><strong>Methods:</strong> Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT.  </p><p class="abstract"><strong>Results:</strong> Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.</p><p class="abstract"><strong>Conclusions:</strong> HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations.  </p>


Author(s):  
Anuj Kumar Shukla ◽  
S. K. Kanaujia ◽  
Sandeep Kaushik ◽  
Nishant Saurabh Saxena

<p class="abstract"><strong>Background: </strong>Tympanometry and computed tomography (CT) measurement of middle ear volume in patients with unilateral chronic otitis media.</p><p class="abstract"><strong>Methods: </strong>The prospective study was conducted on 50 patients of diagnosed unilateral chronic otitis media showing clinical symptoms which affect quality of life. Patients who were fulfilling inclusion criteria after screening were selected for study. We studied patients who had a unilateral tympanic membrane (TM) perforation and a normal TM in the contralateral ear which act as control group to estimate the ME volume in the lesioned ear. Further we have compared pre and postoperative middle ear volume (measured by CT and tympanometry) in control &amp; diseased ear to correlate middle ear volume results obtained by CT and Tympanometry.</p><p class="abstract"><strong>Results: </strong>The mean value of MEV measured by tympanometry and CT were (1.343±0.580) and (1.106±0.380) respectively (Figure 1). Volume measurement by tympanometry is higher as compared to volume measured by CT in lesioned ear, hence tympanometry measured volume in diseased ear were higher that measured by CT which is closer to normal values in both normal and Diseased ears. Also hearing shows improvement in diseased ear after surgery due to restoration of middle ear volume closer to normal.</p><p class="abstract"><strong>Conclusions:</strong> It was concluded in our study that CT is more reliable investigation for middle ear volume measurement as compared to Tympanometry in diseased as well as normal ears.</p>


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