Poor Pneumatization Research Articles

上鼓室陥凹の臨床的研究

Attic retraction was studied in 327 ears of 264 patients in whom photographs of the tympanic membrane were taken from 1983 to 1989. Attic retraction was investigated clinically on the basis of findings of the tympanic membrane in reference to the photographs and ear X-ray findings, including CT. Attic retraction was also observed in 4.5% of cases without inflammation, but its severity was mild. The incidence of attic retraction in cases of adhesive otitis media was 42.7% in mild adhesive otitis media (adhesive grade I) and 60.8% in severe adhesive otitis media (adhesive grade II), both incidences were significantly higher than the incidence of 23.8% in cases of otitis media with effusion. Thus, the incidence of attic retraction increased as the grade of adhesion became severer. In cases of otitis media with effusion, the incidence was significantly higher in the adult group (32.3%) than in the child group (17.4%). In many of the ears with otitis media with effusion, adhesive grade I and chronic otitis media, the severity of attic retraction was mild. There were more cases of milder retraction in the child group than in the adult group. Attic retraction underwent change with time in 2.8% of cases, and cholesteatoma occurred in 1.8% of cases. No improvement in attic retraction was achieved by insertion of a ventilation tube. Bilateral attic retraction was observed in 56.9% of the child group and 30.2% of the adult group, and the difference was statistically significant. Ear X-ray findings by Schüller's method revealed many ears with poorly developed mastoid cells and poor pneumatization.(ABSTRACT TRUNCATED AT 250 WORDS)

MR findings in mannosidosis

MR findings are reported in three patients presenting mannosidosis. Among a family of 8 children, 4 presented typical clinical and biological abnormalities related to mannosidosis. Brain MR examinations including sagittal T1 and axial T2 sections were obtained in three patients of this family (one 25-year-old male, one 34-year-old female, and one 35-year-old female). MR scans demonstrate seven types of modifications: (1) brachycephaly, (2) thick calvaria, (3) verticalization of the chiasmatic sulcus, (4) poor pneumatization of the sphenoid body, (5) partial empty sella turcica (6) cerebellar atrophy, and (7) white matter signal modifications. High signal abnormalities involving the parieto-occipital white matter are identified on axial T2-weighted scans in the three patients and are probably related to demyelination and associated gliosis as described previously by several authors on specimens.

中耳真珠腫の対側耳の観察

To clarify whether or not a common pathogenic factor exists between the affected and contralateral ear in patients with cholesteatoma, we performed the measurement mastoid pneumatization and a inflation-deflation test in 92 contralateral ears.About 70% of the contralateral ears showed abnormal findings of the ear drum. The majority of the contralateral ears showed poor pneumatization. Therefore, we considered these cases to reflect impaired tubal function in childhood. The conditions of the contralateral ears were similar to those of the affected ears, suggesting a common pathogenic factor in this disorder.

Pneumatization and thickness of the petrous bone in patients with Meniere's disease. A histopathological study.

Histological evaluations were made of the degree of pneumatization and thickness of the petrous bone surrounding the vestibular aqueduct, and of the relationships of these parameters to the condition of the vestibular aqueduct in 27 temporal bones with idiopathic endolymphatic hydrops from individuals with Meniere's disease. The results were compared with those from the same parameters in 79 control temporal bones without endolymphatic hydrops from individuals who had no premortem history of otologic disease. Pneumatization of the temporal bones of patients with Meniere's disease was in most cases less than that of control temporal bones; this difference was statistically significant. Poor pneumatization of the temporal bones of individuals with Meniere's disease appeared to be closely associated with hypoplasia of the vestibular aqueduct, an anatomical feature of many individuals with Meniere's disease. However, no statistically significant difference could be found between the thickness of the petrous bone in the periaqueductal region in bones of patients with Meniere's disease and this parameter in control bones.

Clinical Investigation of Nystagmus and Pneumatization of the Temporal Bone

Poor pneumatization of the temporal bone and of the short aqueducts may predispose to Meniere's disease. The size of the mastoid pneumatization was examined roentgenographically and measured by planimetry in 82 normal persons and 196 patients with vertigo or dizziness.The affected ears with Meniere's disease and sudden deafness showed a tendency to smaller mastoid pneumatization. The smaller mastoid pneumatization of the affected ears was observed in 40.9% of patients with Meniere's disease, in 58.8% of those with sudden deafness, and in 21.5% of those with normal ears.The relationship between the degree of pneumatization and several symptoms of Meniere's disease was investigated in patients who had suffered many vertigo attacks. In many cases of unilateral Meniere's disease the affected ears with poorer pneumatization also showed more canal parese in the caloric response than did those with normal or better pneumatization. But no relationship was observed between other nystagmic signs and pneumatization.

Long term results of treatment of middle ear effusion.

Ten years follow-up of 48 patients (33 boys, 15 girls) with middle ear effusion treated by adeno-tonsillectomy, antral lavage and paracentesis is presented. Using the modified but stricter classification of Tos and Poulsen, the results compare well (Table V). Agreement between otoscopy and impedance measurement was remarkably high. It was noted that the greater the number of repeated paracenteses, the higher the compliance rose above normal, but there was no relation to the viscosity of the fluid found. In ears in which grommets were used, only in 10 per cent was the tympanic membrane found to be normal at otoscopy and impedance measurement, as compared with 55 per cent of ears which did not receive a ventilation tube. Poor pneumatization of mastoids indicated a poor prognosis. Sinus infection was present in the majority of cases treated. Another finding of interest was a patulous Eustachian tube in six patients--one bilateral and five unilateral. Despite the vast amount of literature published describing various combinations of treatment in the management of middle ear effusion, the challenge remains. Long term follow-up results for various methods employed would be welcome.

Calvarial bone defects in neurofibromatosis.

A rare case of neurofibromatosis with calvarial bone defects is reported. There was involvement of the right lambdoid suture which has not been previously mentioned in the radiologic literature. There was also poor pneumatization of the right mastoid.

Size of the human mastoid air cell system.

The area of mastoid pneumatization was measured on 68 children's ears and, after simple mastoidectomy, the cavity volume was determined. Another measurement was made utilizing the dural tegmen and sigmoid plate laminae as limiting structures. This “laminal limits'' figure corresponded well with cavity volume, but in small children the air cell area was significantly smaller. Several factors are responsible for absent or poor pneumatization: if infection starts in infancy, mastoid pneumatization does not start or is arrested until normal conditions prevail in the middle ear. Mastoiditis in small children may result in marked new bone formation and subsequent sclerosis, and air cell formation fails to penetrate this barrier even if the middle ear is restored to normal. In a well pneumatized ear, persisting infection in the mastoid process causes obliteration of the cells already existing and the end result resembles cases of primary arrested pneumatization.

Otitis media and complications; summaries of the bibliographic material available in the field of Otolaryngology for 1951.

IN THE 1951 literature are numerous interesting articles, some of which must have required much time and work in their preparation. Reviewer's notes will appear in brackets. ANATOMY Schwartz 1 (Halifax, Nova Scotia) became interested in the influence of heredity on the type of pneumatization in mastoids when he found three persons in one family who had sclerotic mastoids. He x-rayed 25 pairs of identical twins and found their cellular development similar. Seven patients who had had otitis media during infancy were studied, and five had both mastoids well pneumatized, one had diploic mastoids, and one had poor pneumatization. He then x-rayed 13 families, one of them containing 54 members, and recorded the structure types. There were altogether 223 patients x-rayed and studied. He is convinced that heredity is the probable explanation of the different types of bone and the extent of pneumatization present and that Wittmaack's theory is not