The Clinical Significance of Epitympanic Mucosal Folds

Aimi, Kenji

doi:10.1001/archotol.1971.00770070799004

Cited by 16 publications

(6 citation statements)

References 5 publications

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“…Considering that at least 90% of all children have had secretory otitis media at least once, about 50% have had it several times, and about 30% have had severe and long‐lasting secretory otitis media, 16 it is likely that the common histological changes seen in normal temporal bones represent sequelae of suppurative or chronic secretory otitis media. This is in agreement with the findings and conclusions of Aimi 3,4 . Further, quantitative histological studies on the human middle ear mucosa in ears with a normal drum revealed many cases with mucosal folds.…”

Section: Conclusion and Discussionsupporting

confidence: 92%

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Pathogenesis of Middle Ear Adhesions

et al. 1996

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Middle ear adhesions are well-known to the ear surgeon, although data on etiology, pathogenesis, and significance are lacking in current literature. This study on experimental acute otitis media presents histopathological data on these aspects. Pneumococci were inoculated in the right middle ear bulla of 25 rats; the left ear served as control. At days 4, 8, 16, 90, and 180, respectively, 5 rats were decapitated, and the bullae were removed, opened, and stained with periodic acid-Schiff (PAS)/alcian blue. The entire middle ear mucosae were dissected from the bone, embedded as whole mounts in colophonium chambers, and examined by light microscopy. Representative parts of the mucosae were sectioned and examined in the same way. All inoculated ears from day 8 and later (20 in total), contained mucosal adhesions of various sizes, shapes, and locations. None were found in control ears. The site of predilection for the development of adhesions was the hypotympanum, followed by the anterior epitympanum, the attic, the drum, the interossicular spaces, and the tubal orifice. Based on present histopathological findings, we conclude that the middle ear adhesion is a pathological phenomenon caused by infection, and we propose a six-stage hypothesis of pathogenesis: 1. Localized epithelial rupture; 2. Prolapse of subepithelial tissue; 3. Epithelialization of the prolapse; resulting in a polypous/fold-like prominence; 4. Growth and elongation of the prominence; 5. Fusion of the end/tip of the prominence with another part of the mucosa; 6. Formation of an adhesion.

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Section: Conclusion and Discussionsupporting

confidence: 92%

“…These folds are supposedly remnants of the embryological sacs, and Proctor considers them as mesenteries, carrying blood to the ossicles. Aimi studied 500 fresh temporal bones and found considerable variations to be common; he also had difficulty differentiating between these supposedly congenital folds and inflammatory webs 3,4 …”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of Middle Ear Adhesions

et al. 1996

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“…The most common locations from which cholesteatoma arise are the posterior epitympanum, posterior mesotympanum and the anterior epitympanum. Enlarging cholesteatomas are chanelled along characteristic pathways by surrounding mucosal folds, ossicular suspensory ligaments, and the ossicles themselves [3,4,5]. Epitympanic cholesteatomas originate in a shallow nearly closed pocket that lies between the pars fl accida of the tympanic membrane and the neck of the malleus.…”

Section: Discussionmentioning

confidence: 99%

Atticoantral disease — revisited

Kumar

et al. 2007

Indian J Otolaryngol Head Neck S

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“…folds were reported elsewhere. 2 Mucosa! fold pathology related to the tympanic isthmus is briefly reviewed .…”

Section: Aditus Blockmentioning

confidence: 99%

The Tympanic Isthmus: Its Anatomy And Clinical Significance

Aimi¹

1978

The Laryngoscope

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The tympanic isthmus is a narrow passage between the tubotympanic cavity and the at-ti~omastoid air space. Obstruction of the tympanic isthmus is frequent in various types of middle ear disease and causes significant air-diffusion disturbance within the temporal bone pneumatic system.Using large numbers of fresh temporal bone specimens, anatomical boundaries of the ty!11panic isthmus are defined and pathological variations are investigated. Embryological ong1?? of the isthmus and pathophysiological implications of the tympanic isthmus block are discussed.Among factors that cause obstruction of the tympanic isthmus are mucosa! folds variations, inflammatory webs and exudate, retracted tympanic membrane, diseased attic mucosa, and cholesteatoma. Each factor is analyzed with representative specimen photographs.Clinical signs due to tympanic isthmus block often simulate or coexist with symptoms of eustachian tube obstruction. Surgical management of the tympanic isthmus block requires clear recognition of these disease processes.Understanding of the tympanic isthums as an anatomical entity is essential in the management of middle ear and attic disease.

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The Clinical Significance of Epitympanic Mucosal Folds

Cited by 16 publications

References 5 publications

Pathogenesis of Middle Ear Adhesions

Pathogenesis of Middle Ear Adhesions

Atticoantral disease — revisited

The Tympanic Isthmus: Its Anatomy And Clinical Significance

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