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Endoscopic evaluation of the patency of the aditus in tubotympanic type of chronic suppurative otitis media

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Abstract

Objectives

Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM).

Study design

Prospective escriptive study.

Methods

This study carried out on 50 patients presenting with inactive tubo-tympanic CSOM with only mild or moderate conductive hearing loss, attending the Alexandria university hospital (tertiary referral center). Tympanoplasty was done for all patients. The patency and dimensions of the aditus were assessed by performing antral window through which 30Ί endoscope was introduced. Biopsy was taken from unhealthy mucosa to detect the presence of hidden cholesteatoma or granulation tissue.

Results

Ten out of 50 (20%) patients had blocked aditus. The dimensions of the aditus were measured. Biopsy taken from these cases revealed a granulation tissue in all cases. No hidden cholesteatoma was detected.

Conclusion

In inactive tubo-tympanic CSOM with mild or moderate conductive hearing, the aditus was not always patent. It was obstructed in 20% of our study.

References

  1. 1

    Habib MA, Huq MZ, Aktaruzzaman M, Alam MS, Joarder AH, Hussain MA. Outcome of tympanoplasty with and without cortical mastoidectomy for tubotympanic chronic otitis media. Mymensingh Med J 2011; 20: 478–483.

    CAS  PubMed  Google Scholar 

  2. 2

    Holmquist J, Bergstrom B. The mastoid air cell system in ear surgery. Arch Otolaryngol 1978; 104: 127–129.

    CAS  Article  Google Scholar 

  3. 3

    Sade J. The correlation of middle ear aeration with mastoid pneumatization. The mastoid as a pressure buffer. Eur Arch Otorhinolaryngol 1992; 249: 301–304.

    CAS  Article  Google Scholar 

  4. 4

    Baylan FR, Celikanat S, Aslan A, Taibah A, Russo A, Sanna M. Mastoidectomy in non cholesteatomatous chronic suppurative otitis media: Is it necessary? Otolaryngol Head Neck Surg 1997; 117: 592–595.

    Article  Google Scholar 

  5. 5

    Hamada Y, Utahashi H, Aoki K. Physiological gas exchange in the middle ear cavity. Int J Pediatr Otorhinolaryngol 2002; 64: 41–49.

    Article  Google Scholar 

  6. 6

    Okubo J, Noshiro M. Analysis of middle ear cavity gas composition by mass spectrometry. Nihon Jibiinkoka Gakkai Kaiho 1994; 97: 1181–1190.

    CAS  PubMed  Google Scholar 

  7. 7

    Palva T, Ramsay H. Incudal folds and epitympanic aeration. Am J Otol 1996; 17: 700–708.

    CAS  PubMed  Google Scholar 

  8. 8

    Marchioni D, Molteni G, Presutti L. Endoscopic anatomy of the middle ear. Indian J Otolaryngol Head Neck Surg 2011; 63: 101–113.

    Article  Google Scholar 

  9. 9

    Marchioni D, Alicandri-Ciufelli M, Molteni G, Artioli FL, Genovese E, Presutti L. Selective epitympanic dysventilation syndrome. Laryngoscope 2010; 120: 1028–1033.

    PubMed  Google Scholar 

  10. 10

    Albu S, Trabalzini F, Amadori M. Usefulness of cortical mastoidectomy in myringoplasty. Otol Neurotol 2012; 33: 604–609.

    Article  Google Scholar 

  11. 11

    Vijayendra H, Mahadevaiah A, Surendran K, Sangeetha R. Micro ear surgery — its purpose and procedure for tubotympanic pathology. Indian J Otolaryngol Head Neck Surg 2005; 57:360–363.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. 12

    Ruhl CM, Pensak ML. Role of aerating mastoidectomy in non cholesteatomatous chronic otitis media. Laryngoscope 1999; 109: 1924–1927.

    CAS  Article  Google Scholar 

  13. 13

    Long X, Feng X, Zhu J, Guo M, Xie M. Normal anatomy of aditus of antrum and antrum on high-resolution CT and three-dimensional reconstruction. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 26: 747–750.

    PubMed  Google Scholar 

  14. 14

    Manjunath MK, Swarup RJ, Chary G, Shadab MD. Myringosclerosis: an indication of a blocked aditus. Indian J Otolaryngol Head Neck Surg 2012; 64: 230–232.

    CAS  Article  Google Scholar 

  15. 15

    Migirov L, Volkov A. Influence of coexisting myringosclerosis on myringoplasty outcomes in children. J Laryngol Otol 2009; 123: 969–972.

    CAS  Article  Google Scholar 

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Corresponding author

Correspondence to Yasser G. Shewel MD.

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There are no conflicts of interest.

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Bassiouny, M., Shewel, Y.G. & Yassin, M. Endoscopic evaluation of the patency of the aditus in tubotympanic type of chronic suppurative otitis media. Egypt J Otolaryngol 32, 45–48 (2016). https://doi.org/10.4103/1012-5574.175846

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Keywords

  • aditus
  • dry tympanic perforation
  • otitis media