Three-Dimensional Image Analysis of the Temporal Bone in Patients with Unilateral Attic Cholesteatoma

Tsai, Li Tai; Wang, C. Y.; Lo, Yu Chien; Lin, Chia Der; Tsai, Ming-Hsui

doi:10.1177/197140091002300308

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…The imaging findings associated with ETD have not been extensively described, with only six published papers identified as describing features detectable on imaging that are suggestive of ETD [ 12 , 24 , 32 , 40 – 42 ]. All except one [ 24 ] are based on CT findings (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Two groups found that the bony channel for the Eustachian tube within the temporal bone was of reduced cross sectional size in individuals with obstructive ETD [ 12 , 40 ], and one group found that the tube ran at a shallower angle in diseased ears [ 42 ]. Kanzaki et al highlight one of the weaknesses of using CT to assess soft tissues; as by scanning pre- and post-grommet insertion, they demonstrated that mucus and fluid cannot easily be distinguished from soft tissue obstructing the lumen [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

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Imaging of the Eustachian tube and its function: a systematic review

2016

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IntroductionThe Eustachian tube is a complex and inaccessible structure, which maintains middle ear ventilation to facilitate transmission of sound from the tympanic membrane to the cochlea. A renewed interest in treatments for eustachian tube dysfunction has led to a demand for methods of imaging the Eustachian tube, and assessing tube opening non-invasively. This review aims to summarise the use of imaging in the anatomical assessment of the Eustachian tube, and to explore how radiological techniques can be used to assess tube function.MethodsA systematic review of the literature was performed with narrative data analysis.ResultsWith high-resolution images, the soft and bony anatomy of the Eustachian tube can be assessed in detail. CT and MRI are best suited to identifying features associated with obstructive or patulous Eustachian tube dysfunction, though true assessments of function have only been achieved with contrast enhanced radiographs and scintigraphy. A single modality has yet to provide a complete assessment. No test has entered routine clinical use, but further development and research is underway.ConclusionSignificant information can be gained from imaging the Eustachian tube, and as faster acquisition techniques are developed, it is possible that dynamic imaging of tubal opening could play an important role in the assessment of patients with ET dysfunction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Imaging of the Eustachian tube and its function: a systematic review

2016

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“…The three arms have been selected to reflect the variation in current practice, with all interventions already in widespread clinical use. Oral steroid (prednisolone) is included as an intervention as this is recommended in guidelines [ 16 ], and used by most ENT clinicians across the UK [ 23 , 24 ]. As the current standard of care, this represents the control intervention.…”

Section: Discussionmentioning

confidence: 99%

“… American Academy of Otolaryngology–Head & Neck Surgery hearing recovery criteria [ 16 ]. Classification shown with the associated audiometric criteria.…”

Section: Methodsmentioning

confidence: 99%

Protocol for a multicentre randomised controlled trial of STeroid Administration Routes For Idiopathic Sudden sensorineural Hearing loss: The STARFISH trial

Smith,

Knappett,

Vickers

et al. 2024

PLoS ONE

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Idiopathic sudden sensorineural hearing loss (ISSNHL) is the rapid onset of reduced hearing due to loss of function of the inner ear or hearing nerve of unknown aetiology. Evidence supports improved hearing recovery with early steroid treatment, via oral, intravenous, intratympanic or a combination of routes. The STARFISH trial aims to identify the most clinically and cost-effective route of administration of steroids as first-line treatment for ISSNHL. STARFISH is a pragmatic, multicentre, assessor-blinded, three-arm intervention, superiority randomised controlled trial (1:1:1) with an internal pilot (ISRCTN10535105, IRAS 1004878). 525 participants with ISSNHL will be recruited from approximately 75 UK Ear, Nose and Throat units. STARFISH will recruit adults with sensorineural hearing loss averaging 30dBHL or greater across three contiguous frequencies (confirmed via pure tone audiogram), with onset over a ≤3-day period, within four weeks of randomisation. Participants will be randomised to 1) oral prednisolone 1mg/Kg/day up to 60mg/day for 7 days; 2) intratympanic dexamethasone: three intratympanic injections 3.3mg/ml or 3.8mg/ml spaced 7±2 days apart; or 3) combined oral and intratympanic steroids. The primary outcome will be absolute improvement in pure tone audiogram average at 12-weeks following randomisation (0.5, 1.0, 2.0 and 4.0kHz). Secondary outcomes at 6 and 12 weeks will include: Speech, Spatial and Qualities of hearing scale, high frequency pure tone average thresholds (4.0, 6.0 and 8.0kHz), Arthur Boothroyd speech test, Vestibular Rehabilitation Benefit Questionnaire, Tinnitus Functional Index, adverse events and optional weekly online speech and pure tone hearing tests. A health economic assessment will be performed, and presented in terms of incremental cost effectiveness ratios, and cost per quality-adjusted life-year. Primary analyses will be by intention-to-treat. Oral prednisolone will be the reference. For the primary outcome, the difference between group means and 97.5% confidence intervals at each time-point will be estimated via a repeated measures mixed-effects linear regression model.

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“…A few studies have indicated that acquired cholesteatoma is associated with bone formation and absorption, but most of these studies are case reports, animal tests, or cytology studies [ 3 – 5 ]. A previous study indicated that acquired cholesteatoma is associated with anatomical abnormalities or other bone diseases such as osteoporosis [ 9 ]. However, no large-scale epidemiological study has been conducted to investigate this association.…”

Section: Introductionmentioning

confidence: 99%

Increased Acquired Cholesteatoma Risk in Patients with Osteoporosis: A Retrospective Cohort Study

et al. 2015

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ObjectiveClinically, we found the increased incidence of acquired colesteatoma in the patients with osteoporosis. In this study, we used a retrospective cohort to examine this association and to investigate the possible mechanism.MethodsWe conducted a population-based retrospective cohort study by using the National Health Insurance Research Database (NHIRD). We identified an osteoporosis cohort comprising 37 124 patients newly diagnosed with osteoporosis aged 20 years or older. Patients in the comparison cohort had no history of osteoporosis and were frequency matched with the patients in the osteoporosis cohort according to sex, age, and index year.ResultsThe acquired cholesteatoma incidence rates for the osteoporosis and comparison cohorts were 1.12 and 0.83 per 1000 person-years, respectively. After we adjusted for confounding factors, the osteoporosis cohort exhibited a 1.32-fold increased acquired cholesteatoma risk relative to the comparison cohort (hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 1.11–1.57). In addition, patients with no history of otitis media (HR = 1.33, 95% CI = 1.11–1.59), cancer (HR = 1.34, 95% CI = 1.12–1.60), or COPD (HR = 1.26, 95% CI = 1.05–1.52) in the osteoporosis cohort exhibited an increased risk of subsequent acquired cholesteatoma relative to those in the comparison cohort.ConclusionsOur cohort study indicated that patients with osteoporosis had a 1.31-fold increased acquired cholesteatoma risk relative to the comparison cohort. This risk was further increased in patients with comorbid otitis media. Hence, we recommend that otolaryngologists evaluate the condition of the middle ear of patients with osteoporosis.

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Three-Dimensional Image Analysis of the Temporal Bone in Patients with Unilateral Attic Cholesteatoma

Cited by 10 publications

References 12 publications

Imaging of the Eustachian tube and its function: a systematic review

Imaging of the Eustachian tube and its function: a systematic review

Protocol for a multicentre randomised controlled trial of STeroid Administration Routes For Idiopathic Sudden sensorineural Hearing loss: The STARFISH trial

Increased Acquired Cholesteatoma Risk in Patients with Osteoporosis: A Retrospective Cohort Study

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