The evaluation of eustachian tube paratubal structures using magnetic resonance imaging in patients with chronic suppurative otitis media

Abstract

Conclusion Eustachian tube (ET) dysfunction, which plays a role in the pathogenesis chronic suppurative otitis media (CSOM), does not seem to be due to differences in paratubal structures. Objective The aim of this study was to compare the magnetic resonance imaging (MRI) findings of the paratubal structures of the ET between normal ears and ears in patients with CSOM. Methods The MRI records of 40 patients who underwent tympanomastoidectomy for a diagnosis of CSOM were reviewed retrospectively. The healthy ears served as the control group. The length, diameter, surface area and volume of the tensor veli palatini muscle (TVPM) and levator veli palatini muscle (LVPM) were measured, in addition to the diameter of the pharyngeal orifice of the ET, volume of the Ostmann fat pad, bimucosal thickness of the lumen of the ET, and mucosal thickness. Results In the pathological ears, the mean length of the TVPM and LVPM was 22.6 mm and 19.3 mm, the mean diameter was 3.2 and 5.3 mm, and the mean volume was 1.75 and 3.2 cm(3), respectively. In addition, the mean diameter of the pharyngeal orifice of the ET was 1.9 mm. There were no significant between-group differences in the paratubal structures (p > 0.05).

Differences in the Tensor Veli Palatini Between Adults With and Without Cleft Palate Using High-Resolution 3-Dimensional Magnetic Resonance Imaging

“…Figure 1 shows the measures that were carried out for each participant. Similar to Terzi et al (2016), variables for the present study included the length of the TVP, diameter of the TVP muscle, TVP muscle volume, bihamular distance, and mucosal thickness of the ET lateral lamina at the pharyngeal orifice. The TVP muscle length was obtained by measuring the muscle from the origin along the lateral lamina of the Eustachian tube to the point at which the muscle descends to wrap around the hamulus.…”

“…Shibahara and Sando (1988) also attribute ET dysfunction among individuals with a history of cleft palate to be a result of numerous ET cartilage abnormalities and the relationship of these structures relative to the TVP. Terzi et al (2016) used magnetic resonance imaging (MRI) to investigate the differences among individuals with chronic suppurative otitis media (CSOM) compared to those with normal ears. Results indicated no significant difference in paratubal structures including: TVP length and volume, diameter of the pharyngeal ET orifice, volume of the Ostamann fat pad, bimucosal ET lumen thickness, and mucosal thickness.…”

A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test

“…While magnetic resonance imaging of the ET and para-tubal structures provides much better soft tissue discrimination than CT, absence of signal from air and the larger voxel sizes pose additional limitations for visualizing the ET lumen. 3,[14][15][16] Currently, the cartilaginous ET lumen can only be identified with CT when it is open, a result of the significant contrast differences between the HU levels of air and soft tissue. However, at rest in normal individuals, the walls of the functional section of the cartilaginous ET lumen are apposed and thus not visible on CT scan.…”

Ostmann’s Fat Pad—Does it Really Matter?

“…However, limitations in measurement methods might have led to less accurate results and underestimating the actual size of the OFP. 18…”