Measuring Thickness of Middle Ear Mucosa Using MRI and CT Imaging versus Histopathology

Objective. Otitis media (OM) is characterized by increased middle ear effusion and inflammation of middle ear tissue. In this study, we compared two radiographic methods of analyzing inflammation by measuring mucosal thickness (MT).Methods. 28 chinchillas were divided into three treatment groups consisting of a vehicle control group and two glucocorticoid groups. 6 underwent treatment by vehicle control, 10 were treated with ciprofloxacin 0.3%/dexamethasone 0.1% (DEX), and 10 received ciprofloxacin 0.2%/hydrocortisone 1% (HC). 96 hrs post-LPS inoculation, chinchillas were euthanized and their temporal bones were removed for analyses.Results. MRI scans (F=146.0861,P-value <0.0001) and histology (χ2=40.5267,P-value <0.0001) revealed statistically significant differences in MT measurements among treatment groups, whereas CT imaging did not. DEX-treated chinchillas exhibited overall significantly smaller MT values.Conclusion. Imaging MT was effective for determining severity of inflammation due to OM. Previous gold standard methods using histopathology compromise tissue integrity by chemical manipulation and dehydration effects. MRI and CT scanning are viable tools to preserve tissue and examine changes in MT. In this study, MRI provided more information about internal, soft tissue structures. In a clinical setting, MRI could be used for diagnosing and tracking severe or chronic OM.

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Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Bangladesh Journal of Endosurgery ◽

10.3329/bje.v2i1.19588 ◽

2014 ◽

Vol 2 (1) ◽

pp. 9-14

Author(s):

Sheikh Shawkat Kamal

Keyword(s):

Middle Ear ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Retrospective Case ◽

Middle Ear Mucosa ◽

Case Series Study ◽

Temporal Bones ◽

Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

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Transtympanic versus intramuscular steroid administration in a histamine-induced inflammatory middle-ear model

The Journal of Laryngology & Otology ◽

10.1017/s0022215106004968 ◽

2006 ◽

Vol 121 (7) ◽

pp. 630-634

Author(s):

T S Chimona ◽

J G Panayiotides ◽

C E Papadakis ◽

E S Helidonis ◽

G A Velegrakis

Keyword(s):

Middle Ear ◽

Inflammatory Activity ◽

Mucosal Inflammation ◽

Control Group ◽

Middle Ear Mucosa ◽

Vascular Dilatation ◽

Group B ◽

Histamine Challenge ◽

Inflammatory Component

Objectives: Assessment of the histopathologic effect of transtympanic and intramuscular administration of dexamethasone in an in vivo experimental animal model of middle-ear mucosal inflammation.Methods: Fifty healthy rabbits weighting 1500–1800 g were randomly divided in three groups. In 10 animals (control group), 0.5 ml of a 20 mg/ml histamine solution was injected transtympanically. In 20 rabbits (group A), histamine challenge followed a three day intramuscular pretreatment with dexamethasone at 1 mg/kg per day. In 20 rabbits (group B), histamine challenge followed pretreatment with dexamethasone via a transtympanic route (0.3 ml, 1.2 mg dexamethasone). Middle-ear mucosa was obtained for histopathology 30 minutes after histamine administration. The following parameters were assessed: inflammation, acute inflammatory component, presence of eosinophils, inflammatory activity and fibrosis.Results: Oedema, vascular dilatation and congestion, inflammation, the presence of an acute (polymorphonuclear) inflammatory component, the presence of eosinophils, and inflammatory activity were found to be of a lesser grade in the mucosae of group B. All differences were found to be statistically highly significant (p<0.01) using the Mann–Whitney test.Conclusion: Our findings validate the transtympanic route of dexamethasone administration in counteracting histamine effects.

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Effects of Platelet Activating Factor on Vascular Permeability of the Middle Ear Mucosa

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600714 ◽

1997 ◽

Vol 106 (7) ◽

pp. 604-607 ◽

Cited By ~ 5

Author(s):

Chung-Ku Rhee ◽

Yong-Soo Park ◽

Timothy T. K. Jung ◽

Steven A. Long ◽

David Davamony

Keyword(s):

Vascular Permeability ◽

Middle Ear ◽

Normal Saline ◽

Evans Blue ◽

Inflammatory Mediator ◽

Otitis Media With Effusion ◽

Platelet Activating Factor ◽

Control Group ◽

Middle Ear Mucosa ◽

Potent Inflammatory Mediator

Platelet activating factor (PAF), a potent inflammatory mediator, seems to play a significant role in the pathogenesis of otitis media with effusion (OME), along with other inflammatory mediators such as leukotrienes and prostaglandins. The purpose of this study was to investigate the effect of PAF on the vascular permeability of middle ear mucosa, in an experimental OME model using chinchillas. We injected PAF in doses of 1, 4, 8, and 16 μg and normal saline as a control into the bullae of chinchillas. Vascular permeability was measured by the Evans blue vital dye technique. All the PAF-injected animals showed a significant increase in middle ear vascular permeability compared to the control group. This study demonstrated that PAF in the middle ear cavity contributes significantly to the development of OME by increasing the vascular permeability of the middle ear mucosa.

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Safety and Efficacy of Chitosan-Dextran Hydrogel in the Middle Ear in an Animal Model

Audiology and Neurotology ◽

10.1159/000447623 ◽

2016 ◽

Vol 21 (4) ◽

pp. 254-260

Author(s):

Selin Ünsaler ◽

Bora Başaran ◽

Şule Öztürk Sarı ◽

Eyüp Kara ◽

Kemal Değer ◽

...

Keyword(s):

Middle Ear ◽

Auditory Brainstem ◽

Contralateral Side ◽

Auditory Brainstem Responses ◽

Control Group ◽

Ear Surgery ◽

Significant Difference ◽

Intratympanic Injection ◽

Temporal Bones ◽

Histopathologic Findings

Objectives: To investigate the efficacy of chitosan-dextran hydrogel (CDH) in preventing postoperative adhesions between the tympanic membrane (TM) and intratympanic structures, and to evaluate its ototoxicity in an animal study. Methods: In the first step, ototoxicity was evaluated with 7 male albino guinea pigs (GPs) via auditory brainstem responses (ABR) before and 4 weeks after unilateral intratympanic injection of CDH and saline solution contralaterally. In the second step, 12 GPs underwent bilateral ear surgery. The middle ear (ME) mucosa was abraded, and the cavity was filled with CDH on one side and packed with Gelfoam on the contralateral side. A control group of 6 GPs underwent the same procedure except that no material was applied in the ME. The animals were euthanized at the end of the 7th week, and otomicroscopic findings were noted and the temporal bones harvested for the histologic examination. The findings were scored and compared. Results: There was no statistically significant difference between the pre- and postoperative ABR thresholds. In the otomicroscopic findings, the most prominent difference between the two groups was the presence of retraction of the TM in the Gelfoam group. The histopathologic findings revealed a higher degree of inflammation in the Gelfoam group compared with the CDH group. Conclusion: This study demonstrated that CDH has no ototoxic effects in GPs. Its use as an ME packing material revealed significantly less TM retraction and inflammatory reaction compared with Gelfoam.

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The anti-inflammatory effects of erythromycin, clarithromycin, azithromycin and roxithromycin on histamine-induced otitis media with effusion in guinea pigs

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000610 ◽

2018 ◽

Vol 132 (7) ◽

pp. 579-583 ◽

Cited By ~ 7

Author(s):

B Ersoy ◽

B Aktan ◽

K Kilic ◽

M S Sakat ◽

S Sipal

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Guinea Pigs ◽

Otitis Media With Effusion ◽

Study Groups ◽

Control Group ◽

Middle Ear Mucosa ◽

Anti Inflammatory ◽

The Right ◽

Better Than

AbstractBackgroundOtitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion.MethodsThe animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear.ResultsThe lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10−5/μm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10−5/μm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin.ConclusionThe use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.

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Mucous Glands in the Middle Ear and Osseous Eustachian Tube

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947308200117 ◽

1973 ◽

Vol 82 (1) ◽

pp. 80-88 ◽

Cited By ~ 16

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.

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MICRO-CT Imaging of Thiel-Embalmed and Iodine-Stained Human Temporal Bone for 3D Modeling

10.1101/2020.12.15.20247536 ◽

2020 ◽

Author(s):

Halm Sebastian ◽

Haberthuer David ◽

Eppler Elisabeth ◽

Djonov Valentin ◽

Arnold Andreas

Keyword(s):

Soft Tissue ◽

Temporal Bone ◽

Middle Ear ◽

3D Modeling ◽

Ct Imaging ◽

Micro Ct ◽

Data Set ◽

Iodine Staining ◽

Tissue Structures ◽

Temporal Bones

ABSTRACT OBJECTIVE The following study investigates whether human Thiel-embalmed temporal bones are suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and the effect of solid iodine staining for improved visualization and facilitated segmentation of middle ear structures. METHODS One temporal bone was used to verify the accuracy of the imaging by measuring the stapes digitally on the tomography images and physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and 3D modeling after iodine staining and micro-CT scanning. RESULTS The digital and physical stapes measurements differ up to 0.17 mm and 24% but correlate well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. CONCLUSION Micro-CT imaging of Thiel-embalmed temporal bones accurately represents the entire anatomy. Iodine staining considerably increases the contrast of soft tissues, simplifies segmentation and enables detailed 3D modeling of the middle ear, which is suitable for further use as a finite element model (FEM).

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Otological findings in idiopathic hyperphosphatasia

The Journal of Laryngology & Otology ◽

10.1017/s0022215100143440 ◽

1999 ◽

Vol 113 (2) ◽

pp. 158-160 ◽

Cited By ~ 2

Author(s):

Levent Sennaroǧlu ◽

Bulent Sozeri ◽

Arzu Sungur

Keyword(s):

Hearing Loss ◽

Middle Ear ◽

Mixed Type ◽

Ossicular Chain ◽

Otic Capsule ◽

Progressive Hearing Loss ◽

Middle Ear Mucosa ◽

Superior Part ◽

Bony Mass ◽

Temporal Bones

AbstractA 17-year-old male patient was admitted because of progressive hearing loss since the age of six. His former blood and radiology investigation had revealed idiopathic hyperphosphatasia. On ENT examination bilateral thickened tympanic membranes with severe mixed-type hearing loss was diagnosed. Computerized tomography (CT) demonstrated expansion of the calvarial bones, including the temporal bones, except for the otic capsule. Middle-ear exploration revealed thickened middle-ear mucosa and a stone hard, immobile bony mass instead of the normal ossicular chain at the posterior superior part of the mesotympanum. No ossicular reconstruction could be attempted and the patient was rehabilitated with a hearing aid.

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Fate of Middle Ear Mucosa Introduced into the Vestibule

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947908800216 ◽

1979 ◽

Vol 88 (2) ◽

pp. 241-246

Author(s):

Andrew W. Miglets ◽

F. Donald Coopey

Keyword(s):

Inflammatory Response ◽

Mucous Membrane ◽

Animal Study ◽

Middle Ear ◽

Squirrel Monkeys ◽

Granuloma Formation ◽

Middle Ear Mucosa ◽

The Right ◽

Temporal Bones ◽

Possible Cause

The etiology of poststapedectomy reparative granuloma remains obscure. To evaluate the possibility of inadvertently introduced mucous membrane into the vestibule as a possible cause of granuloma formation, this animal study was devised. The stapes was removed from the right ear of four squirrel monkeys and middle ear mucosa placed in the vestibule, the stapes then being replaced. In the left ear, a control operation was done in which only the stapes was removed, then replaced. The animals were sacrificed between the 2nd and 17th day and their temporal bones were prepared and studied. The mucous membrane was identified within the vestibule of all animals. It was well-tolerated and did not evoke the inflammatory response, which would be expected if mucosa was a cause of granuloma formation. The mucosa was still present at 17 days, eventually becoming surrounded by the endosteal lining of the vestibule.

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Possible role of Dickkopf-1 protein in the pathogenesis of tympanosclerosis in a rat model

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001566 ◽

2017 ◽

Vol 131 (10) ◽

pp. 860-865

Author(s):

Y Zhang ◽

S Wang ◽

Y Zheng ◽

A Liu

Keyword(s):

Middle Ear ◽

Morphological Changes ◽

Control Group ◽

Sprague Dawley ◽

Middle Ear Mucosa ◽

Inflammatory Infiltration ◽

Sprague Dawley Rats ◽

Sclerotic Lesions ◽

Tympanic Membranes

AbstractObjectives:This study aimed to investigate the expression of DKK1 protein in an experimental model of tympanosclerosis and its possible role in the pathogenesis of this disorder.Methods:Forty Sprague Dawley rats were included in the study: 20 in the control group (which received no treatment) and 20 in the experimental group (which received an incision to induce tympanosclerosis). Otomicroscopy was performed to observe the development of myringosclerosis. Haematoxylin and eosin staining was performed to observe the morphological changes. Western blot analysis and immunohistochemistry were performed to assess the expression of DKK1 protein.Results:At day 15, sclerotic lesions were observed in 70 per cent of the tympanic membranes. Inflammatory infiltration and hyaline degeneration markedly appeared in the tympanic membranes and middle-ear mucosa. DKK1 protein was mainly distributed in the cytoplasm of epithelial cells, which were widely distributed in the tympanic membranes and middle-ear mucosa. The expression of DKK1 protein was significantly decreased in the calcified experimental ears.Conclusion:DKK1 protein is involved in the pathogenesis of tympanosclerosis by regulating the Wnt/β-catenin signalling pathway.

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