Ostmann’s Fat Pad—Does it Really Matter?

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.

Download Full-text

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

The Journal of Laryngology & Otology ◽

10.1017/s0022215120002182 ◽

2020 ◽

pp. 1-12

Author(s):

P J Clamp ◽

K De-Loyde ◽

A R Maw ◽

S Gregory ◽

J Golding ◽

...

Keyword(s):

Cohort Study ◽

Otitis Media ◽

Maternal Education ◽

Univariate Analysis ◽

Chronic Otitis Media ◽

Birth Cohort Study ◽

Control Group ◽

Factors Associated ◽

Prospective Longitudinal

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.

Download Full-text

Chronic Otitis Media with Effusion in Chronic Sinusitis with Polyps

Ear Nose & Throat Journal ◽

10.1177/014556131809700803 ◽

2018 ◽

Vol 97 (8) ◽

pp. E13-E18 ◽

Cited By ~ 3

Author(s):

Mary Daval ◽

Hervé Picard ◽

Emilie Bequignon ◽

Philippe Bedbeder ◽

André Coste ◽

...

Keyword(s):

Otitis Media ◽

Nasal Polyposis ◽

Otitis Media With Effusion ◽

Demographic Data ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Upper Airway ◽

Control Group ◽

Cross Sectional ◽

Significant Difference

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.

Download Full-text

Location of the middle cranial fossa dural plate in patients with chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215113003526 ◽

2014 ◽

Vol 128 (1) ◽

pp. 60-63 ◽

Cited By ~ 1

Author(s):

S Genc ◽

M G Genc ◽

I B Arslan ◽

A Selcuk

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Middle Cranial Fossa ◽

Control Group ◽

Adjacent Structures ◽

Cranial Fossa ◽

The Mean ◽

Bone Scans ◽

The Right ◽

And Control

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.

Download Full-text

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

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0039-3399518 ◽

2019 ◽

Vol 81 (01) ◽

pp. 082-087

Author(s):

Ozkan Ozen ◽

Caner Sahin

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Venous Drainage ◽

Control Group ◽

Automation System ◽

High Resolution Computed Tomography ◽

Emissary Veins ◽

Pass Through ◽

Mastoid Foramen ◽

Mastoid Region

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.

Download Full-text

Tympanometry and computed tomography measurement of middle ear volumes in patients with unilateral chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211181 ◽

2021 ◽

Vol 7 (4) ◽

pp. 609

Author(s):

Anuj Kumar Shukla ◽

S. K. Kanaujia ◽

Sandeep Kaushik ◽

Nishant Saurabh Saxena

Keyword(s):

Computed Tomography ◽

Otitis Media ◽

Middle Ear ◽

Clinical Symptoms ◽

Chronic Otitis Media ◽

Volume Measurement ◽

Mean Value ◽

Control Group ◽

Measured Volume

Background: Tympanometry and computed tomography (CT) measurement of middle ear volume in patients with unilateral chronic otitis media.Methods: 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 & diseased ear to correlate middle ear volume results obtained by CT and Tympanometry.Results: 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.Conclusions: 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.

Download Full-text

Ototoxicity of ear drops in patients suffering from chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100108011 ◽

1989 ◽

Vol 103 (1) ◽

pp. 46-50 ◽

Cited By ~ 24

Author(s):

L. Podoshin ◽

M. Fradis ◽

J. Ben David

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Otitis Media ◽

Medical Center ◽

Local Treatment ◽

Chronic Otitis Media ◽

Polymyxin B ◽

Sensorineural Hearing ◽

Control Group ◽

Ear Drops

AbstractThe sensorineural hearing loss in 150 patients with chronic otitis media who were treated in the Haifa Medical Center (Rothschild) during a ten year period was studied. There were 124 patients treated with a mixture containing neomycin, polymyxin B and dexamethasone and a control group of 26 patients with dexamethasone only.All patients were followed up for a period of 1–2 years. Patients with hearing loss due to factors such as previous ear surgery, family history, exposure to noise etc., have been excluded.The conclusions reached were that there is a relationship between the period of disease and the sensorineural hearing loss and that the local treatment with a mixture containing neomycin + polymyxin B appears to contribute to the worsening of the sensorineural hearing loss in patients with chronic otitis media.Our numbers are small and further studies must be done, but the fact that currently used ear drops may produce a sensorineural hearing loss should not be ignored.

Download Full-text

Serum matrix metalloproteinases and tympanosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s002221511000201x ◽

2010 ◽

Vol 125 (2) ◽

pp. 142-146 ◽

Cited By ~ 2

Author(s):

H Aslan ◽

M Sinan Başoğlu ◽

B Şentürk ◽

C Özbay ◽

H Katilmiş ◽

...

Keyword(s):

Matrix Metalloproteinases ◽

Matrix Metalloproteinase ◽

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Control Group ◽

Success Rates ◽

Tissue Inhibitor ◽

Matrix Metalloproteinase 1 ◽

Significant Difference

AbstractAim:To investigate levels of matrix metalloproteinases 2 and 9, and of their tissue inhibitor (i.e. tissue inhibitor matrix metalloproteinase 1), in the serum of patients with tympanosclerosis.Materials and method:We included 40 patients (age range 13–63 years) who had undergone surgery in the ENT department of İzmir Atatürk Training and Research Hospital between 2002 and 2007. Twenty had uncomplicated chronic otitis media and 20 had tympanosclerosis. We also included as the control group 20 individuals with no history of previous otic complaints or systemic or infectious disease. Serum levels of serum matrix metalloproteinases 2 and 9 and of tissue inhibitor matrix metalloproteinase 1 were measured in all subjects and compared.Result:Significantly higher levels of serum matrix metalloproteinases 2 and 9 were found in the tympanosclerosis group, compared with the chronic otitis media and control groups. There was no statistically significant difference in tissue inhibitor matrix metalloproteinase 1 level between the three groups.Conclusion:Tympanosclerosis surgery has poor success rates, since the pathological process is still active. We suggest that high levels of matrix metalloproteinases may play a role in the continuation of the disease process.

Download Full-text

Does Ostmann's fat pad size correlate with development of chronic otitis media in children?

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2021.110710 ◽

2021 ◽

Vol 145 ◽

pp. 110710

Author(s):

Ameen Biadsee ◽

Vered Weisz ◽

Feda Fanadka ◽

Abed Abu-Elhija ◽

Tom Ben-Dov ◽

...

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Fat Pad

Download Full-text

LINKING CHRONIC OTITIS MEDIA AND NASAL OBSTRUCTION: A CFD APPROACH

10.22541/au.161309075.58258865/v1 ◽

2021 ◽

Author(s):

Manuel Antonio Burgos Olmos ◽

Alejandro Antunez ◽

Rafael Romero ◽

Beatriz Balbuena ◽

David Castro ◽

...

Keyword(s):

Nasal Cavity ◽

Otitis Media ◽

Chronic Otitis Media ◽

Control Group ◽

Nasal Airflow ◽

Left Nasal Cavity ◽

Computational Fluid Dynamics Cfd ◽

Flow Through ◽

The Right ◽

Nasal Flow

ABSTRACT OBJECTIVES: To investigate a possible relationship between altered nasal flow and chronic otitis media (COM) using computational fluid dynamics (CFD). DESIGN: Retrospective cohort sample of CT scans from patients with COM and controls without COM to compare the results of various nasal airflow parameters determined by CFD between a group of patients with COM (N=60) and a control group of subjects without any evidence of ear disease (N=81). MAIN OUTCOME MEASURES: The CT were subjected to various procedures to carry out CFD studies, determining the resistance to nasal flow, the proportion of flow through the right and left nasal cavity, and two nondimentional estimators. The results of CFD studies between patients with COM and controls were compared. RESULTS AND CONCLUSIONS: Whereas only 12.3% of the controls had CFD alteration (10 out of 81), 43.3% of the patients suffering COM displayed alterations of our nondimentional parameters (26 out of 60). According to our results, the incidence of alterations in nasal airflow by studying with CFD is significantly higher in patients with COM than in controls IMPLICATIONS: To our knowledge, this is the first paper linking nasal cavity and COM using a CFD approach. Our results support the hypothesis that nasal flow alterations could be implicated in the etiopathogenesis of the COM.

Download Full-text

Anterior epitympanic attic antrum space obstruction and symptom onset associated with myringosclerosis in benign chronic suppurative otitis media

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202235 ◽

2020 ◽

Vol 8 (6) ◽

pp. 2013

Author(s):

Zulfikar Naftali ◽

Suprihati . ◽

Dharmana E. ◽

Setyawan H.

Keyword(s):

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Symptom Onset ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Control Group ◽

Chi Square ◽

Suppurative Otitis Media ◽

Control Approach

Background: The AAA (Anterior epitympanic, Attic, and Antrum) space is the space between the mastoid and middle ear which functions to balance the pressure in both organs (buffer). Pathological tissue in the AAA cavity due to chronic infection would disrupt the buffer function and could change the morphology of the mucosa in the tympanic membrane and middle ear. Obstruction in the AAA space measured subjectively by observing the smoothness of the flow using saline solution has been shown to be associated with a plaque in the tympanic membrane (myringosclerosis) in Chronic Otitis Media (COM) patients. This study aims to determine the relationship between AAA space obstructions with myringosclerosis using CT-Scan for an objective result.Methods: Retrospective study with case-control approach used in this study. Case criterias are Chronic Suppurative Otitis Media (CSOM) patients with myringosclerosis, both men and women and age 15-50 years, while the control group are benign CSOM patients without myringosclerosis. Data were analyzed with the chi-square test to prove the association between the AAA space status and length of symptom onset with myringosclerosis.Results: During January 2017-December 2019 there were 33 respondents, 19 cases and 14 controls, 21 men and 12 women with an average age of 35 years (cases) and 23.5 years (control). The length of symptom onset more than 5 years (p <0.05, OR 6.94 with CI 0.5-1.5) and AAA space obstruction (p <0.05 OR 34.25 with CI 0.8-1.8) has been shown to be associated with myringosclerosis in people with benign CSOM.Conclusions: AAA space obstruction and symptom onset more than 5 years significantly associated with myringosclerosis.

Download Full-text