Type of Article: Original Research
Year: 2016 | Volume 4 | Issue 1 | Page No. 1777-1780
Date of Publication: 31-01-2016
ASSOCIATION OF EUSTACHIAN TUBE DYSFUNCTION IN CHILDHOOD WITH MASTOID PNEUMATIZATION
Samanwita Basak *1, Subhojit Mondal 2, Satabdi Sarkar 3, Sudipto Konar 4, Moulik Debnath 5, Manimay Bandopadhyay 6.
*1,2 Demonstrator, Department of Anatomy, Murshidabad Medical College, West Bengal, India.
3 Assistant professor, Department of Anatomy, Murshidabad Medical College, West Bengal, India.
4 Assistant professor, Department of Anatomy, Burdwan Medical College, West Bengal, India.
5 Assistant professor, Department of Anatomy, Murshidabad Medical College, West Bengal, India.
6 Professor & Head, Department of Anatomy, Murshidabad Medical College, West Bengal, India.
Address: Dr. Samanwita Basak, MBBS, MD. Demonstrator, Department of Anatomy, Murshidabad Medical college, West Bengal, India. Pin-742101
Background: Degree of temporal bone pneumatization plays a very crucial role to assess the prognosis of different inflammatory middle ear diseases and the success of middle ear surgeries. There are debates regarding theories of the control of mastoid pneumatization. While the ‘Hereditary theory’ says that mastoid size is independent of status of mesotympanum the ‘Environmental theory’ supports the fact that the size of mastoid air cell system (MACS) is dependent on the degree of pathological involvement of middle ear mucosa in childhood.
Purpose: This study aims to establish the relationship between less pneumatic mastoid in eastern Indian population with history of (h/o) childhood eustachian tube (ET) dysfunction and temporary unhealthy middle ear mucosa.
Materials and Method: 100 subjects(n=100) of more than 6 years age (irresepective of sex) were selected who had no h/o past or present chronic or recurrent middle ear infection though subjects with one or two episodes of middle ear ailments in childhood were not excluded. Then by routine ENT examinations it was confirmed that they were having clinically healthy middle ear. Afterwards their bilateral mastoid x-rays were taken and typing (pneumatic/ diploic/ sclerotic/asymmetric) was done.
Results and Discussion: From the obtained data it was found that 31.58% of cases with bilateral diploic mastoid; 80% of cases with bilateral sclerotic mastoid and 75% of cases with asymmetric mastoid provided the h/o infantile ET dysfunction. This significant association of childhood ET dysfunction with depressed pneumatization (bilateral / unilateral) supports the ‘environmental theory’. This study also estimated that individual with infantile ET dysfunction is 7 times more prone to develop non-pneumatic mastoid than an unexposed one. It emphasises on the importance of early diagnosis and prompt treatment of childhood ET dysfunction and also enlightens and encourages future research works in this regard.
KEY WORDS: Eustachian tube dysfunction, Mastoid air cell system, Mastoid pneumatization, Sclerotic mastoid.
- Sade J. & Amos AR.The Eustachian Tube.In: Ludman H. & Wright T. editors. Diseases of the ear.6th ed.India: JP;2006.P 341-343.
- Tumarkin A. On the nature and vicissitudes of the accessory air spaces of the middle ear. J Laryngol Otol 1957;71:210-248.
- Holmquist J. Aeration in chronic otitis media. Clin Otolaryngol 1978; 3: 278-284.
- Austin DF. On the function of the mastoid. Otolaryngol Clin North Am, 1977;10:541-7.
- Nakano Y, Sato Y. Prognosis of otitis media with effusion in children, and size of the mastoid air cell system. Acta Otolaryngol (Stockh) 1990 (Suppl);471:56-61.
- Sui X, Li Q, Wang Y. Mastoid pneumatization and secretory otitis media. Zhonghua Er Bi Yan Hou Ke Za Zhi. 1996;31(6):331-333.
- Holmquist J. Size of mastoid air cell system in relation to healing after myringoplasty and to Eustachian tube function. Acta Otolaryngol (Stockh) 1970;69:89-93.
- Bonding P. Tympanoplasty in children. Acta Otolaryngol (Stockh) 1988;449:199-201.
- Bonding P, Satage J. Tympanoplasty in children: when? In: Sade J, ed. Infections in childhood. Amsterdam, the Netherlands. Excerpta Medical International Series. 1994;1040:172-183.
- Albrecht W. Acta otolaringologica 1930;14:221-quoted by quoted by “Diseases of the Ear, Nose and Throat”, Ed by W.G.Scott-Brown.4th ed., vol-1, Butterworths, London; 1979.
- Diamant M.,Dahlberg G. Inheritance of pneumatization of the mastoid bone. Hereditas(Lund) 1945;31:441-456-quoted by Diamant M. Pneumatization of the nastoid bone.J.L.O. 1958 ;72(5):343-364.
- Tumarkin A. On the nature and significance of hypocellularity of mastoid. J Laryngol Otol 1959;73:34-44.
- Arora M.M.L.,Sain U.,Sodhi J.S. Mastoid pneumatization in children-a roentgenographic planimetric study.Indian Journal of Otolaryngology and Head & Neck Surgery 1973;25:87-90.
- Frisberg K, Ingelstedt S, Ortegren U. On middle ear pressure. Acta Otolaryngol (Suppl)(Stockh) 1963;182:43-55.
- Sade J, Fuchs C. Secretory otitis media in adults: II. The role of mastoid pneumatization as a prognostic factor. Ann Otol Rhinol Laryngol 1997;106:37-40.
- Woolley A.L, Oser AB, Lusk RD. Preoperative temporal bone computed tomography scan and its use in evaluating the paediatric cochlear implant candidate. Laryngoscope 1997;107(8):1100-1106.
- Wittmaack K. Über die normale und Pathologische Pneumatization des Schlafenbeins einschiesslich ihrer Beziehungen zu der Mittelohrerkrankungen. Fischer, Jena, Germany 1918, p.1-64.
- Kolihova E, Abraham J, Blahova O. Rezidivierende Mittelohrentzündung im frühen Kindesalter und ihr Einfluss an die Zellsystementwicklung des Schlafenbeins. Radiologie 1966;12:62-65.
- Siedentop KH. Eustachian tube dynamics, size of mastoid air cell system and results with tympanoplasty. Otolaryngol clin North Am1968;5:33-44.
- Andreasson L. Correlation of tubal function and volume of mastoid and middle ear space as related to otitis media. Ann Otol Rhinol Laryngol 1976;85:198-203.
- Aoki K, Esaki S, Honda Y, Tos M. Effect of middle ear infection of pneumatization and growth of the mastoid process. An experimental study in pigs. Acta Otolaryngol (Stockh) 1990;110:399-409.
- Ikarashi F, Nakano Y, Okura T. The relationship between the degree of chronic middle ear inflammation and tympanic bulla pneumatization in the pig as an animal model. Eur Arch Otorhinolaryngol 1994;251:100-104.
Samanwita Basak, Subhojit Mondal, Satabdi Sarkar, Sudipto Konar, Moulik Debnath, Manimay Bandopadhyay. ASSOCIATION OF EUSTACHIAN TUBE DYSFUNCTION IN CHILDHOOD WITH MASTOID PNEUMATIZATION. Int J Anat Res 2016;4(1):1777-1780. DOI: 10.16965/ijar.2015.334