The significance and fate of the mesenchyme of the middle ear

Guggenheim, Paul; Clements, Leo P.; Schlesinger, Allan

doi:10.1288/00005537-195610000-00004

Cited by 33 publications

(23 citation statements)

References 13 publications

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“…This is consistent with temporal bone studies that have reported presence of mesenchyme in the middle ear cleft up to 13 mo of age (Guggenheim et al, 1956;Kasemsuwan et al 1996;Jaisinghani et al, 1999). However, these results need to be substantiated using audiological and radiological studies in live infants.…”

Section: Discussionsupporting

confidence: 90%

“…In humans, although the resorption of mesenchyme from the middle ear cleft is reported to be complete by the eighth foetal month, it can vary up to the thirteenth postnatal month (Guggenheim et al, 1956;Buch and Jorgensen, 1964;Arey, 1968) with some children retaining large amounts of mesenchyme until the onset of puberty (Takahara et al, 1986). Temporal bone studies have shown that persistent amniotic fluid cellular content can spread to various middle ear compartments and cause extensive histopathological changes due to foreign body giant cell reaction, the severity of which is related to the amount of amniotic cellular content (Piza et al, 1989;Northrop et al, 1999;Palva, Northrop & Ramsay, 1999).…”

Section: Discussionmentioning

confidence: 99%

“…The middle ear and antrum of a neonate have been reported to contain some amniotic fluid or residual mesenchyme and its cellular content. Studies have shown that in the early stages of foetal development, the middle ear is filled with mesenchyme, which resolves between 8 foetal months to 13 postnatal months (Guggenheim, Clements, & Schlesinger, 1956;Jaisinghani, Paparella, Schachern, & Le, 1999;Piza, Gonzalez, Northrop, & Eavey, 1989;Takahara et al, 1986).…”

Section: External/middle Ear Pathology and Conductive Hearing Loss Inmentioning

confidence: 99%

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Wideband absorbance measures in neonates and young infants

Aithal¹

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Evaluation of middle ear status in young infants is a challenge in both screening and diagnostic contexts due to a lack of valid and objective tools of middle ear assessment . The standard tools used to determine the middle ear status in older children are neither efficient nor accurate in evaluating young infants.Wideband absorbance (WBA) is recommended as a tool for middle ear assessment in young infants due to its time efficiency, reliability, objectivity and ability WBA. The neonates were tested prior to their discharge from the hospital. In addition, a total of 36, 30, 33 and 30 infants were seen at 1, 2, 4, and 6 months of age, respectively. These infants were tested using HFT, DPOAE and WBA.The results revealed that conductive hearing loss was common among infants referred through NHS. Australian Aboriginal infants had significantly higher rates of middle ear pathology and conductive hearing loss at birth and showed poor resolution of middle ear pathology over time compared to non-Aboriginal infants. Use of a test of middle ear function (eg. WBA) as an adjunct to the screening tool to facilitate management and prioritisation of infants for further testing was recommended (Chapter Two). Normative ambient pressure WBA data were established for 66 neonates who passed a test battery of AABR, HFT, ASR, TEOAE and DPOAE tests. There was a significant difference in WBA across frequencies from 250 to 8000 Hz (Chapter Three). Test performance of WBA was compared across four single tests and five test battery reference standards in 192 neonates. The test performance of WBA against the test battery reference standards was better than that against single test reference standards (Chapter Four). Despite equal pass rates as determined by a test battery of HFT and DPOAE, the WBA of Aboriginal neonates who passed the test battery was significantly lower suggesting that Aboriginal neonates had more significant outer/middle ear conditions than Caucasian neonates. WBA appeared to be more sensitive to middle ear status than test battery comprising HFT and DPOAE (Chapter Five). In a cross sectional study of infants, developmental effects were evident during the first six months of life, with WBA reducing with age. Although data from the study could be used as reference standard for detecting middle ear disorders, further development of age-specific normative WBA was recommended (Chapter Six).

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: External/middle Ear Pathology and Conductive Hearing Loss Inmentioning

confidence: 99%

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Wideband absorbance measures in neonates and young infants

Aithal¹

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“…In a study that described silent otitis media in infants, Guggenheim et al [16] discussed the controversial role of mesenchyme and whether it provided a predisposition toward or a protective immunologic function against the occurrence of otitis media. In humans, complete resorption of mesenchyme in the middle ear has been reported to range from the 8th fetal month [16] to the 13th postnatal month [17] with some children retaining a large amount of mesenchyme until the onset of puberty.…”

Section: Residual Mesenchymementioning

confidence: 99%

“…In humans, complete resorption of mesenchyme in the middle ear has been reported to range from the 8th fetal month [16] to the 13th postnatal month [17] with some children retaining a large amount of mesenchyme until the onset of puberty. Kasemsuwan et al [18] studied temporal bones of children from birth to 5 years of age for the presence of unresolved mesenchyme.…”

Section: Residual Mesenchymementioning

confidence: 99%

Chronic Silent Otitis media

Paparella

Schachern

Cüreoğlu

2002

ORL

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Otitis media occurs along a continuum. For example, otitis media with effusion characterized by fluid pathology can lead to chronic otitis media plus chronic mastoiditis, characterized by the presence of intractable tissue pathology such as cholesteatoma, cholesterol granuloma or granulation tissue. The literature defines chronic otitis media as having a tympanic membrane perforation and otorrhea. Amongst many other sequelae, which can result from the continuum, an important common one is chronic silent otitis media. This overlooked entity which includes pathology beneath an intact tympanic membrane is commonly seen in our human temporal bone laboratory and in patients. The clinical pathological correlates of this important disease are discussed herein.

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Direct Adenoidectomy: III. Results

Guggenheim¹

1957

Archives of Otolaryngology - Head and Neck Surgery

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The significance and fate of the mesenchyme of the middle ear

Cited by 33 publications

References 13 publications

Wideband absorbance measures in neonates and young infants

Wideband absorbance measures in neonates and young infants

Chronic Silent Otitis media

Direct Adenoidectomy: III. Results

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