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.

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>

scholarly journals Comparative Study of Preoperative Radiological Findings with Intraoperative Surgical Findings in Squamosal Type of Chronic Otitis Media

2021 ◽  
Vol 10 (25) ◽  
pp. 1862-1865
Author(s):  
Sanjana Pradeep ◽  
Swaroop Dev ◽  
Jyothi Swarup Raju ◽  
Shravya Pasunuti
Keyword(s):  
Temporal Bone ◽  
Otitis Media ◽  
Semicircular Canal ◽  
Chronic Otitis Media ◽  
Sigmoid Sinus ◽  
Lateral Semicircular Canal ◽  
High Resolution Computed Tomography ◽  
Tissue Mass ◽  
Hrct Temporal Bone ◽  
A Prospective Study

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

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.

Intact-Bridge Tympanomastoidectomy

1984 ◽  
Vol 92 (3) ◽  
pp. 334-338 ◽  
Author(s):  
Michael M. Paparella ◽  
Timothy T.K. Jung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Primary Objective ◽  
Open Cavity ◽  
Mastoid Obliteration ◽  
Closed Cavity ◽  
One Stage ◽  
Secondary Objective ◽  
Good Exposure

In recent years closed-cavity (intact wall) tympanomastoidectomy has been described and recommended by many. The pendulum now is swinging back to open-cavity tympanomastoidectomy. The literature in this regard is reviewed. In all patients with chronic otitis media and mastoiditis with intractable tissue pathology, the primary objective is total eradication of disease with a dry, safe ear; a concomitant but secondary objective is hearing retention and restoration with tympanoplasty techniques. Over a 3-year period we have used a one-stage procedure called intact-bridge tympanomastoidectomy (IBM) that fulfills the desirable objectives of both open-and closed-cavity tympanomastoidectomy. The salient features include (1) good exposure as in open-cavity tympanomastoidectomy, (2) maintenance and widening of the middle ear space by bony bridge retention and facial buttress sculpturing to enhance grafting and ossiculoplasty such as TORP or PORP as in canal-up tympanomastoidectomy, and (3) enhancement of mastoid obliteration for large cavities by blocking the aditus with bone paté or cartilage and by providing a separation between middle ear and mastoid. Specific methods, techniques, and results will be presented and discussed.

Characterization of mucins in human middle ear and Eustachian tube

2001 ◽  
Vol 280 (6) ◽  
pp. L1157-L1167 ◽  
Author(s):  
Jizhen Lin ◽  
Vladimir Tsuprun ◽  
Hirokazu Kawano ◽  
Michael M. Paparella ◽  
Zhiqiang Zhang ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Middle Ear Mucosa ◽  
Pathological Conditions ◽  
Mucin Expression ◽  
Mucin Genes ◽  
Human Middle Ear

Mucins are important glycoproteins in the mucociliary transport system of the middle ear and Eustachian tube. Little is known about mucin expression within this system under physiological and pathological conditions. This study demonstrated the expression of MUC5B, MUC5AC, MUC4, and MUC1 in the human Eustachian tube, whereas only MUC5B mucin expression was demonstrated in noninflamed middle ears. MUC5B and MUC4 mucin genes were upregulated 4.2- and 6-fold, respectively, in middle ears with chronic otitis media (COM) or mucoid otitis media (MOM). This upregulation of mucin genes was accompanied by an increase of MUC5B- and MUC4-producing cells in the middle ear mucosa. Electron microscopy of the secretions from COM and MOM showed the presence of chainlike polymeric mucin. These data indicate that the epithelium of the middle ear and Eustachian tube expresses distinct mucin profiles and that MUC5B and MUC4 mucins are highly produced and secreted in the diseased middle ear. These mucins may form thick mucous effusion in the middle ear cavity and compromise the function of the middle ear.

scholarly journals Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection

2015 ◽  
Vol 84 (1) ◽  
pp. 356-364 ◽  
Author(s):  
Takashi Hirano ◽  
Satoru Kodama ◽  
Toshiaki Kawano ◽  
Masashi Suzuki
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Haemophilus Influenzae ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Murine Model ◽  
Chronic Otitis Media ◽  
Culture Positive

NontypeableHaemophilus influenzae(NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (107CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4+CD25+FoxP3+Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear.

Multiple Osteomas of Eustachian Tube Causing Ipsilateral Otitis Media

2020 ◽  
Vol 16 (8) ◽  
pp. 1052-1054
Author(s):  
Suzan Saylisoy
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Suture Line ◽  
Limited Data ◽  
Radiological Features ◽  
Middle Ear Ventilation ◽  
Basic Functions ◽  
Anatomical Area

Background: Middle ear ventilation and the drainage of secretions are the basic functions of the eustachian tube. Eustachian tube (ET) dysfunction can lead to otitis media. Multiple causes of ET dysfunction exist; ET obstruction is one of them. Osseous obliteration of ET is quite rare. In the literature, there are two cases of solitary osteoma and a case of hamartoma with an osseous content in the ET. Herein, this report describes the case of a patient with multiple osseous lesions consistent with osteomas in the ET, causing ipsilateral otitis media with CT findings. Case Report: A 53-year-old woman presented with left-sided intermittent otalgia and otorrhea. Temporal bone computed tomography showed opacification of middle ear consistent with otitis media and nearly complete blockage of the left ET lumen with multiple osseous lesions wall probably consistent with osteomas on the left side. Conclusion: There are limited data about the radiological features of ET osteoma due to its rare occurrence. Radiographically, external ear osteoma generally appears as a single pedunculated hyperdense mass on CT scan originating from the tympanosquamous or tympanomastoid suture line and extending into the auditory canal with otherwise preserved canal dimensions. Considering this information, osseous lesions arising from ET bone wall and extending into the lumen in the present case were considered as osteomas. Especially in the case of unilateral chronic otitis media, ET should not remain a neglected anatomical area.

Correlation of Tubal Function and Volume of Mastoid and Middle Ear Space as Related to Otitis Media

1976 ◽  
Vol 85 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Lars Andréasson
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Mucosal Damage ◽  
Cell System ◽  
Tubal Function ◽  
Functional Volume ◽  
Air Cells ◽  
Mastoid Air Cells

In 69 ears with chronic otitis media and nine ears with traumatic perforations tubal function, the size of the mastoid air cell system measured planimetrically on roentgenograms and the functional volume of the air filled ear spaces were studied for any correlations. The roentgenographic area and the functional volume were also studied for any variation in the duration of the disease. A correlation was found between abnormally small volumes and impaired tubal function, probably due to mucosal damage of the whole system, i.e. Eustachian tube, middle ear and mastoid air cells. No such association was found between area and tubal function. The volume, but not the area, decrease with the duration of the disease.

scholarly journals Assessment of eustachian tube dysfunction in middle ear pathologies

2018 ◽  
Vol 5 (1) ◽  
pp. 127
Author(s):  
T. Dinesh Singh ◽  
C. P. Sudheer
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Eustachian Tube Function ◽  
Auditory Tube ◽  
Postoperative Assessment ◽  
Tube Dysfunction ◽  
Tube Function

<p class="abstract"><strong>Background:</strong> Auditory tube dysfunction is suspected as primary cause of chronic otitis media and leads to surgical related complications in otitis media with tympanic membrane perforation. The diagnosis of eustachian tube malfunction is essential to know the pathogenesis of chronic otitis media.</p><p class="abstract"><strong>Methods:</strong> A total 150 cases and 75 age, sex matched control subjects between age group 20-50 years were selected. Pre and post-surgical history was noted and detailed ear examination, tympanometry was done. Auditory tube function was evaluated through Valsalva test, nasopharyngoscopy, pneumatic otoscopy. Intact tympanic membrane was assessed by Williams test, perforated tympanic membrane by Toynbee’s test.  </p><p class="abstract"><strong>Results:</strong> Postoperative assessment of eustachian tube function by Toynbee’s test for 19 cases with failed tympanoplasty showed normal ET function in 5 cases, 8 cases had partial and 6 cases had gross ET dysfunction. Postoperative assessment ET function by William’s test showed 4 cases among 19 cases had partial ET dysfunction and 01 cases had gross ET dysfunction.</p><p class="abstract"><strong>Conclusions:</strong> Efficient surgical outcome of middle ear complications always depends on eustachian tube function. Most of the cases with residual CP showed partial or gross ET dysfunction. Patients with tubal dysfunction should be evaluated for underlying cause and treatable causes should addressed before proceeding for surgery as it increases the success rate of tympanoplasty.</p>

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