Surface area-volume relationships for the mastoid air cell system and tympanum in adult humans: Implications for mastoid function

Swarts, J. Douglas; Doyle, Brendan M. Cullen; Alper, Cüneyt M.; Doyle, William J.

doi:10.3109/00016489.2010.480982

Cited by 37 publications

(57 citation statements)

References 15 publications

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“…If too much mucosa remains, the surface area/volume ratio within the mastoid can exceed that of the tympanum. When this occurs, modeling predicts that the mastoid can be expected to act as a gas sink, even if adequately aerated [22] .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Mastoid Function with Magnetic Resonance Imaging after Canal Wall Up Cholesteatoma Surgery

Parkes

Cushing²,

Papsin³

et al. 2016

Int Adv Otol

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OBJECTIVE:To use magnetic resonance imaging (MRI) to assess the extent of mastoid opacification after canal wall up (CWU) cholesteatoma surgery. MATERIALS and METHODS:Thirty-five children in whom post-operative MRI had been obtained after CWU surgery. Cholesteatoma confined to the meso-and/or epi-tympanum was removed using a transcanal approach (n=18). More extensive disease required a combined approach tympanomastoidectomy (CAT, n=17). Mastoid opacification was assessed in both ears by a neuroradiologist blind to surgical details using an ordinal scale from 0 (no opacification) to 6 (completely opacified). The primary outcome measure was presence of normal mastoid ventilation, defined by evaluation of non-operative ears as a score ≤2. The presence of normal ventilation, as well as the raw opacification scores, were compared according to type of cholesteatoma surgery: 1) transcanal, with no mastoidectomy and 2) CAT. RESULTS:Mastoid ventilation was normal in 18 post-operative ears (51%). There was no significant difference in the proportion of normally ventilated mastoids in the CAT (n=17) and transcanal (n=18) groups (p=0.318; Fisher's exact). However, mastoid opacification scores were significantly higher in the CAT group than in the transcanal group (p=0.036; Mann-Whitney U). CONCLUSION:The mastoid frequently fails to become normally ventilated after cholesteatoma surgery. Subgroup analysis suggests cortical mastoidectomy does not increase the likelihood of normal mastoid ventilation after CWU cholesteatoma surgery. MRI provides a non-invasive tool to assess mastoid function, which contributes to the current debate on optimum surgical strategies for management of the mastoid in cholesteatoma surgery. Further research will determine whether this measure of mastoid health correlates with risk of recurrent cholesteatoma.

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Section: Discussionmentioning

confidence: 99%

Assessment of Mastoid Function with Magnetic Resonance Imaging after Canal Wall Up Cholesteatoma Surgery

Parkes

Cushing²,

Papsin³

et al. 2016

Int Adv Otol

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“…Radiograph-based analyses of adult temporal bones provide estimated surface areas ranging from 12.04 to 16.93 cm 2 (Andreasson and Mortensson, 1975;Sade and Fuchs, 1996). Computed tomography (CT)-based estimates for surface areas of pneumatized spaces within the temporal bone range from 74.78 to 330.01 cm 2 (Park et al, 2000;Swarts et al, 2010). CT-based volumes of normal mastoid air cell systems range from 1.61 mL (cm 3 ) to 20.25 cm 3 (Isono et al, 1999;Aktas and Kutlu, 2000;Park et al, 2000;Luntz et al, 2001;Pata et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Ontogenetic Change in Temporal Bone Pneumatization in Humans

Hill

2011

The Anatomical Record

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Pneumatization of the temporal bone is often included in descriptions of fossils and as a phylogenetic marker, but a number of questions about the evolution, growth, and development of the trait remain. Many studies have analyzed temporal bone pneumatization from a clinical perspective, but a systematic quantification of normal development of pneumatized spaces has not been conducted. In this study, ontogenetic change in the size and organization of temporal bone pneumatization is analyzed in a cross-sectional sample of humans. High resolution computed tomography scans of the temporal bone were acquired from a cross-sectional sample of humans (N ¼ 28). Bone volume fractions, anisotropy, trabecular number, trabecular thickness, surface area, and volume were analyzed to provide information about the organization and size of pneumatized spaces across ontogeny. The results indicate that there are general and region-specific patterns of ontogenetic changes in the organization of pneumatized spaces. These changes reflect the transition from nonpneumatized bone to pneumatized bone. It also demonstrates that those regions that are pneumatized early in ontogeny (such as the mastoid antrum) continue to remodel after the initial period of pneumatization. The dynamic nature of temporal bone pneumatization over ontogeny suggests that this character requires careful consideration when used as a character for phylogenetic analyses. These results demonstrate the importance of comparing individuals from similar developmental stages, especially when completing quantitative analyses of the extent of pneumatization or organization of the spaces. Anat Rec, 294:1103Rec, 294: -1115Rec, 294: , 2011. V V C 2011 Wiley-Liss, Inc.

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“…Eventually, a vacuum is created which can then cause fluid to be drawn into the middle ear space (termed serous otitis media). If the fluid becomes infected, a common ear infection (suppurative otitis media) will eventually be developed [41].…”

Section: Anatomy Of the Temporal Bone 13mentioning

confidence: 99%

“…According to [41], the tympanum is essentially a single large air-cell. However, whereas the mucosa covering the tympanum respects many of the conditions for an efficient gas exchange, the surface area to volume ratio is limited by the tympanum principally being a single large air cell, see Fig.…”

Section: Pressure Regulation and Gas Exchangementioning

confidence: 99%

Image Analysis and Visualization of the Human Mastoid Air Cell System

Cros¹

2015

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Legend: CO cochlea, EC ear canal, FN facial nerve, MACS mastoid air cell system, MC micro-channels, OSS ossicles (manubrium of the incus), TM tympanic membrane, TS trabecular spaces, TYM tympanum (middle ear). Image Analysis and Visualization of the Human Mastoid Air Cell System © 2015 Olivier Cros Department of Biomedical EngineeringLinköping University, Sweden ISBN 978-91-7685-941-4 ISSN 0280-7971 LIU-TEK-LIC-1975:N AbstractFrom an engineering background, it is often believed that the human anatomy has already been fully described. Radiology has greatly contributed to understand the inside of the human body without surgical intervention. Despite great advances in clinical CT scanning, image quality is still related to a limited amount X-ray exposure for the patient safety. This limitation prevents fine anatomical structures to be visible and, more importantly, to be detected. Where such modality is of great advantage for screening patients, extracting parameters like surface area and volume implies the bone structure to be large enough in relation to the scan resolution.The mastoid, located in the temporal bone, houses an air cell system whose cells have a variation in size that can go far below current conventional clinical CT scanner resolution. Therefore, the mastoid air cell system is only partially represented on a CT scan. Any statistical analysis will be biased towards air cells of smaller size. To allow a complete representation of the mastoid air cell system, a micro-CT scanner is more adequate. Micro-CT scanning uses approximately the same amount of X-rays but for a much longer exposure time compared to what is normally allowed for patients. Human temporal bone specimens are therefore necessary when using such scanning method. Where the conventional clinical CT scanner lacks level of minutes details, micro-CT scanning provides an overwhelming amount of fine details.Prior to any image analysis of medical data, visualization of the data is often needed to learn how to extract the structures of interest for further processing. Visualization of micro-CT scans is of no exception. Due to the high resolution nature of the data, visualization of such data not only requires modern and powerful computers, but also necessitates a tremendous amount of time to adjust the hiding of irrelevant structures, to find the correct orientation, while emphasising the structure of interest. Once the quality of the data has been assessed, and a strategy for the image processing has been decided, the image processing can start, to in turn extract metrics such as the surface area or volume and draw statistics from it. The temporal bone being one of the most complex in the human body, visualization of micro-CT scanning of this bone awakens the curiosity of the experimenter, especially with the correct visualization settings.This thesis first presents a statistical analysis determining the surface area to volume ratio of the mastoid air cell system of human temporal bone, from micro-CT scanning using methods previously appl...

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Surface area-volume relationships for the mastoid air cell system and tympanum in adult humans: Implications for mastoid function

Cited by 37 publications

References 15 publications

Assessment of Mastoid Function with Magnetic Resonance Imaging after Canal Wall Up Cholesteatoma Surgery

Assessment of Mastoid Function with Magnetic Resonance Imaging after Canal Wall Up Cholesteatoma Surgery

Ontogenetic Change in Temporal Bone Pneumatization in Humans

Image Analysis and Visualization of the Human Mastoid Air Cell System

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