Cartilaginous Eustachian tube length and carotid canal dehiscence in children: a radiological study

Toll, Ed C.; Browning, Matthew G.; Shukla, Rishi; Rainsbury, James

doi:10.1007/s00405-018-5128-8

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…These studies reported a mean cartilaginous ET length of 24.5 mm in children 18 and 26.7 mm in adults 11 . Unlike the current study, these studies measured the cartilaginous ET on CT to the nearest 0.1 mm by using scans with a slice thickness of 0.63 mm 18 or 0.67 mm 11 . However, these studies compared the ET in a pediatric‐versus‐adult cohort.…”

Section: Discussionmentioning

confidence: 81%

“…These findings are consistent with previous studies that measured the cartilaginous ET on CT imaging. These studies reported a mean cartilaginous ET length of 24.5 mm in children 18 and 26.7 mm in adults. 11 Unlike the current study, these studies measured the cartilaginous ET on CT to the nearest 0.1 mm by using scans with a slice thickness of 0.63 mm 18 or 0.67 mm.…”

Section: Discussionmentioning

confidence: 97%

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Developmental Anatomy of the Eustachian Tube: Implications for Balloon Dilation

Magro

Pastel

Hilton

et al. 2021

Otolaryngol.--head neck surg.

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Objective To describe the developmental anatomy of the eustachian tube (ET) and its relationship to surrounding structures on computed tomography. Study Design Case series with chart review. Setting A tertiary care hospital. Methods ET anatomy was assessed with reformatted high-resolution computed tomography scans from 2010 to 2018. Scans (n = 78) were randomly selected from the following age groups: <4, 5 to 7, 8 to 18, and >18 years. The following were measured and compared between groups: ET length, angles, and relationship between its bony cartilaginous junction and the internal carotid artery and between its nasopharyngeal opening and the nasal floor. Results The distance between the bony cartilaginous junction and internal carotid artery decreased with age between the <4-year-olds (2.4 ± 0.6 mm) and the 5- to 7-year-olds (2.0 ± 0.3 mm, P = .001). The ET length increased among the <4-year-olds (32 mm), 5- to 7-year-olds (36 mm), and 8- to 18-year-olds (41 mm, P < .0001). The cartilaginous ET increased among the <4-year-olds (20 mm), 5- to 7-year-olds (25 mm), and 8- to 18-year-olds (28 mm, P < .0001). The ET horizontal angle increased among the <4-year-olds (17°), 5- to 7-year-olds (21°), and 8- to 18-year-olds (23°, P≤ .003), but the ET sagittal angle did not statistically change after 5 years of age. The height difference between the nasopharyngeal opening of the ET and the nasal floor increased among the <4-year-olds (4 mm), 5- to 7-year-olds (7 mm), and 8- to 18-year-olds (11 mm, P < .0001). Conclusion The ET elongates with age, and its angles and relationship to the nasal floor increase. Although some parameters mature faster, more than half of the ET growth occurs by 8 years of age, and adult morphology is achieved by early adolescence.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 97%

Developmental Anatomy of the Eustachian Tube: Implications for Balloon Dilation

Magro

Pastel

Hilton

et al. 2021

Otolaryngol.--head neck surg.

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“…Also, passive smoke exposure was reported to increase the risk of otitis media in children, but this has not been reported in adults [33]. The eustachian tube is short in children, but in adults it is long and normally closed [34, 35]. That suggests that tobacco smoke does not readily enter the middle ear of adults, resulting in less or no risk of otitis media.…”

Section: Discussionmentioning

confidence: 99%

Higher Prevalence and Severity of Eosinophilic Otitis Media in Patients with Asthma-COPD Overlap Compared with Asthma Alone

Sato,

Seo,

Tagaya

et al. 2023

Int Arch Allergy Immunol

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Introduction: Eosinophilic otitis media (EOM) is well-known to frequently co-exist with adult-onset asthma. Both diseases are similar type 2 inflammation and are considered to have a “one airway, one disease” relationship. Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO), characterized by airway obstruction caused by airway wall thickening (AWT), is a severe condition with a higher incidence of mortality compared to asthma alone or COPD alone. Based on the “one airway, one disease” concept, we hypothesized that the inflammatory pathophysiology of EOM differs depending on its comorbidity with ACO or with asthma alone. Methods: A total of 77 chronic rhinosinusitis (CRS) patients with asthma were enrolled in this study. The subjects were divided into 2 groups: a group with comorbid asthma alone (asthma group; 46 patients), and a group with comorbid ACO (ACO group; 31 patients). The 2 groups were compared and assessed with regard to various factors, including the patients’ clinical characteristics, prevalence rate of EOM, EOM severity, EOMs relationships with smoking and AWT, and the eosinophil and neutrophil cell counts in the middle ear effusion (MEE). Results: The ACO group included significantly more males (p < 0.05), was significantly older (p < 0.05), and showed significantly lower lung function values (FEV1 [L], FEV1 [%pred]) (p < 0.01) compared with the asthma group. The ACO group also had a significant history of smoking as shown by the Brinkman index (p < 0.01) and greater AWT as assessed by high-resolution computed tomography (p < 0.05). The EOM prevalence rate was significantly higher in the ACO group (p < 0.05), especially with increased ACO severity (p < 0.05). The EOM severity was also significantly higher in the ACO group (p < 0.05) and also correlated with the ACO severity (p < 0.05). The pretreatment ear clinical characteristics score and the average air conduction hearing level were significantly higher in the ACO group (p < 0.05). The eosinophil percentage in the MEE/otorrhea was significantly lower in the ACO group (25.3%) than in the asthma group (54.7%) (p < 0.05). Conversely, the neutrophil percentage was significantly higher in the ACO group (75.7% vs. 41.9%) (p < 0.05). Conclusions: Our findings suggest that, in CRS patients with asthma, comorbidity with ACO may be a clinical factor leading to increased EOM prevalence and severity, as well as a higher neutrophil infiltration percentage in the middle ear. Cessation of smoking and early therapeutic intervention for ACO may mitigate progression of bronchial remodeling (i.e., reduce AWT) and help reduce the prevalence and severity of EOM.

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