Study of the Reliability of High Resolution CT Scan Evaluation of Eustachian Tube as Predictor of Predisposition for Chr
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ORIGINAL ARTICLE
Study of the Reliability of High Resolution CT Scan Evaluation of Eustachian Tube as Predictor of Predisposition for Chronic Otitis Media S. Vivek1
•
Unnikrishnan K. Menon1 • C. J. Sandya2 • Ann Maria Polson1
Received: 23 August 2020 / Accepted: 27 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Eustachian tube (ET) dysfunction is one of the predisposing factors for chronic otitis media (COM). This study looks at two parameters in High Resolution Computed Tomography of temporal bone namely tubotympanic angle (TTA) and pretympanic diameter (PTD) and its relationship with COM. The objectives of the study were to compare the tubotympanic angle and pretympanic diameter of the affected ear in patients with unilateral COM with that of healthy controls, and with contralateral non-COM ear. This was a retrospective study done at a tertiary referral hospital. Database of patients who underwent high resolution CT scan of temporal bone over a period of three and half years, was studied. The TTA and PTD of ET were measured with the help of a senior radiologist well-versed in the imaging of temporal bone. Group A consisted of 45 patients with unilateral COM, while Group B comprised 50 patients without COM. Group A was further subgrouped as A1 (COM with cholesteatoma) and A2 (COM without cholesteatoma). The TTA and PTD in COM with cholesteatoma in the affected ear were 147.98 ± 5.89° and 2.84 ± 0.82 mm respectively, and in the unaffected ear, 144.81 ± 6.43° and 3.32 ± 1.19 mm respectively. In Group A, the TTA and PTD in the affected ear of unilateral COM were 146.17 ± 6.11°, 2.97 ± 0.87 mm and in Group B, it was 143.17 ± 6.01° and 3.48 ± 0.85 mm respectively. All these were statistically significant (p value \ 0.05). Increased TTA and & S. Vivek [email protected] 1
Department of ENT, Amrita Institute of Medical Sciences, Kochi, Kerala 682041, India
2
Department of Radiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
reduced PTD of ET may be a predisposing factor for the development of COM and cholesteatoma. Keywords Eustachian tube Chronic otitis media Cholesteatoma High resolution computed tomography
Introduction The Eustachian tube (ET) is a thin tube lined by epithelium extending from the anterior wall of the middle ear to nasopharynx. It is not merely a static pipe but also a dynamic organ comprising a lumen, skeleton, mucosal lining, soft tissues, and muscles. It serves three prime functions, all in relation to the middle ear (ME): ventilation, protection, and clearance of secretions [1, 2]. Alterations in the anatomy and physiology of the ET can affect the ME in multiple ways. One of the commonest of these is chronic otitis media (COM), which is characterized by chronic inflammation of middle ear cleft presenting with recurrent ear discharge through a tympanic membrane perforation. The early detection of COM is crucial because medical and surgical treatment can prevent the potential complications of this disease [3]. Direct evaluation of ET has rema
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