Role of Eustachian Dysfunction and Primary Sclerotic Mastoid Pneumatisation Pattern in Aetiology of Squamous Chronic Otitis Media: A Correlative Study

Abstract

Squamous chronic otitis media (COM) implies formation of a retraction pocket (inactive form) or frank cholesteatoma (active form) in pars tensa or pars flaccida of tympanic membrane. A retraction pocket or frank cholesteatoma are believed to occur due to tubal dysfunction. The present study was undertaken to investigate the pattern of mastoid pneumatisation and Eustachian dysfunction by dynamic slow motion videoendoscopy (DSVE) in cases of both, active and inactive type of squamous chronic otitis media (COM). 52 patients (65 ears) comprising of twentysix ears with pars flaccida squamous disease and 39 ears with Pars Tensa squamous disease were enrolled for the study. DSVE findings, in terms of grade and type of Eustachian dysfunction were noted. Mastoid pneumatization pattern on CT-scans, and peroperative status of mastoid pneumatisation, especially contracted mastoid with anteriorly placed sigmoid sinus or low lying dura were also recorded for every case while performing tympano-mastoidectomy. Primary sclerotic/diploic type of mastoid pneumatisation pattern and Eustachian dysfunction were found to have inverse relationship in the cases of squamous otitis media. Eustachian dysfunction, diagnosed on DSVE, had significant association with both pars flaccida (P = 0.0001) and pars tensa disease (P = 0.0007). Primary sclerotic or diploic mastoid were found to be more common in ears with pars flaccida squamous disease than pars tensa COM (46.15% vs. 38.46%, P \ 0.05).

Study of Clinical Profile and Comparison of Various Dimensions of Chronic Otitis Media among the Adult and Paediatric Population from Rural Area

“…Post-operative middle ear retraction occurs in tympanoplasty with mastoidectomy much more than tympanoplasty without mastoidectomy. Some of the related studies were reviewed [12,13]. Jain et al reported on role of eustachian dysfunction and primary sclerotic mastoid pneumatisation pattern in aetiology of squamous chronic otitis media [12].…”

“…Some of the related studies were reviewed [12,13]. Jain et al reported on role of eustachian dysfunction and primary sclerotic mastoid pneumatisation pattern in aetiology of squamous chronic otitis media [12]. Methwani and Deshmukh reported about Type I Tympanoplasty with or without mastoidectomy in tubotympanic type of chronic suppurative otitis media patients [13].…”

The Relationship Between Eustachian Tube Diameter and Chronic Otitis Media Development

“…15 The importance of the ET in the middle ear has been demonstrated in many studies. 14,16 The distal cartilaginous section of the ET has been primarily held responsible for obstructive ET dysfunction. 17,18 In contrast, there are also studies claiming that the area where most obstruction occurs is the bony section of the ET.…”

Clinical Significance of Körner’s Septum in Relation to Occurrence of Squamous Chronic Otitis Media

“…KS is more persistent in adults than in children in the temporal bone. In a few investigations, KS was observed in chronic otitis media with squamosal disease [ 21 ]. Middle ear ventilation being obstructed by the anatomical blockage is another reason that may contribute to the development of COM.…”