Endoscopic evaluation of middle ear ventilation route blockage☆☆☆
Received 6 April 2009 published online 02 November 2009. Corrected Proof
Abstract
Objectives
To describe middle ear ventilation route blockage, relieved during middle ear endoscopic surgery, and to analyze its association with mastoid hypopneumatization/sclerotization.
Study design
Prospective case series with intraoperative analyses, and with a case-control computed tomographic scan comparison.
Methods
Intraoperative findings during endoscopic middle ear surgery are described. Patients with middle ear ventilation route blockage were included in the study group (22 patients), while patients without middle ear ventilation route blockage were included in the control group (16 patients). An intra-patient and inter-group comparison of evaluated mastoid pneumatization was performed from the preoperative computed tomographic scans.
Results
Middle ear ventilation route blockage was classified into three types (A, B, C) according to intraoperative findings. Intrapatient and intergroup comparisons showed that the presence of blockages of middle ear ventilation trajectories is associated with a statistically significantly higher prevalence of hypopneumatization/sclerotization of the mastoid in the study group, a typical sign of middle ear dysventilation pathologies.
Conclusions
Intraoperative evaluation of the middle ear anatomy during endoscopic surgery for inflammatory pathology allows us to clearly visualize the presence of anatomic blockages of the middle ear ventilation trajectories. These blockages might provoke a sectorial dysventilation of the middle ear, with consequent reduction of pneumatization of the mastoid. Further studies will be able to clarify to what extent selective dysventilation phenomena could be a principal factor in influencing middle ear pressure homeostasis.
University Hospital of Modena, Department of Otolaryngology, Modena, Italy
Corresponding author. University Hospital of Modena, Department of Otolaryngology, Via del Pozzo 71, 4100 Modena, Italy. Tel.: +39 348 7326686.
☆ The authors has contributed to, read, and approved this manuscript. None of the authors has any conflict of interest, financial or otherwise. The manuscript has not been previously published, nor is it under consideration elsewhere.
☆☆ The language has been edited by professional, English speaking science editor.
ABSTRACT