Growth pattern of temporal bone pneumatization: a computed tomography study with consecutive age groups

  • Pengfei Zhao
  • Heyu Ding
  • Han Lv
  • Jing Li
  • Xuehuan Liu
  • Zhenghan Yang
  • Zhenchang WangEmail author
Original Article



To investigate the growth pattern of temporal bone pneumatization (TBP) in consecutive age groups from birth to 18 years old using 3D air-density reconstruction of high-resolution CT (HRCT).


A total of 570 patients under 18 years old who performed temporal bone HRCT and with no structural abnormalities on both sides were included. Nineteen groups were created to represent consecutive ages, with 15 males and 15 females in each group. Volume rendering of air density was performed using a segmentation threshold of − 200 HU to obtain TBP volume of each side. The differences in TBP between the sides, sexes, and ages were statistically analyzed.


The mean volume of TBP was measured as 1.17 ± 0.44 ml in patients less than 1 year old and 6.81 ± 1.93 ml as adult size. High consistencies of TBP volume between different sides or sexes were found in most of age groups. Significant differences were shown between sides only in 9- and 11-year-old female groups (p9 = 0.031, p11 = 0.016) while between sexes only in 6- and 16-year-old groups (p6 = 0.001, p16 = 0.043), although the volume was larger in all the male groups older than 6 years. The curve drawn by the mean volume in consecutive age groups showed that TBP continued to grow linearly in both males and females until they reached 14 years old. The corresponding linear regression equations were as follows: ym = 1.553 + 0.370x, (x ≤ 14 years, R2 = 0.596); yf = 1.561 + 0.304x, (x ≤ 14 years, R2 = 0.565).


The TBP volume shows a linear growth pattern from birth until reaching adult size after 14 years old.


Temporal bone Ear, middle Image processing, Computer-assisted Tomography, X-ray computed Infant Child Adolescent 


Author contributions

PZ: project development, data collection, and manuscript writing. Heyu Ding: data collection and manuscript editing. HL: data collection. JL: data analysis. XL: manuscript editing. ZY: manuscript editing. Z W: project development and data management.


This study was funded by National Natural Science Foundation of China (grant number 81701644), Beijing Natural Science Foundation (Grant number 7172064), Beijing Training Project for the Leading Talents in S & T (Grant number Z141107001514002), Beijing Municipal Administration of Hospitals’ Mission Plan, and Beijing Scholar 2015 (Grant number SML20150101).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Ars B, Dirckx J, Ars-Piret N, Buytaert J (2012) Insights in the physiology of the human mastoid: message to the surgeon. Int Adv Otol 8(2):296–310Google Scholar
  2. 2.
    Berkhout MC, van Rooden CJ, Aalbers RC, el Bouazzaoui LH, Fokkens WJ, Rijntjes E, Heijerman HG (2014) Temporal bone pneumatization in cystic fibrosis: a correlation with genotype? Laryngoscope 124(7):1682–1686. CrossRefPubMedGoogle Scholar
  3. 3.
    Byun SW, Lee SS, Park JY, Yoo JH (2016) Normal mastoid air cell system geometry: has surface area been overestimated? Clin Exp Otorhinolaryngol 9(1):27–32. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Chatterjee D, Ghosh TB, Ghosh BB (1990) Size variation of mastoid air cell system in Indian people at different age groups: a radiographic planimetric study. J Laryngol Otol 104(8):603–605. CrossRefPubMedGoogle Scholar
  5. 5.
    Cinamon U (2009) The growth rate and size of the mastoid air cell system and mastoid bone: a review and reference. Eur Arch Otorhinolaryngol 266(6):781–786. CrossRefPubMedGoogle Scholar
  6. 6.
    Cros O, Knutsson H, Andersson M, Pawels E, Borga M, Gaihede M (2016) Determination of the mastoid surface area and volume based on micro-CT scanning of human temporal bones. geometrical parameters depend on scanning resolutions. Hear Res 340:127–134. CrossRefPubMedGoogle Scholar
  7. 7.
    Csakanyi Z, Katona G, Josvai E, Mohos F, Sziklai I (2011) Volume and surface of the mastoid cell system in otitis media with effusion in children: a case-control study by three-dimensional reconstruction of computed tomographic images. Otol Neurotol 32:64–70. CrossRefPubMedGoogle Scholar
  8. 8.
    de Rezende Barbosa GL, Nascimento Mdo C, Ladeira DB, Bomtorim VV, da Cruz AD, Almeida SM (2014) Accuracy of digital panoramic radiography in the diagnosis of temporal bone pneumatization: a study in vivo using cone-beam-computed tomography. J Craniomaxillofac Surg 42(5):477–481. CrossRefPubMedGoogle Scholar
  9. 9.
    Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K (2014) Pneumatization of mastoid air cells, temporal bone, ethmoid and sphenoid sinuses. any correlation? Indian J Otolaryngol Head Neck Surg 66(4):429–436. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Isono M, Ito A, Nakayama K, Miyashita H, Saito K, Murata K (2003) Computerized assessment of developmental changes in the mastoid air cell system. Int Congr Ser 1254(1254):487–491. CrossRefGoogle Scholar
  11. 11.
    Kizildag B, Bilal N, Yurttutan N, Sarica MA, Gungor G, Baykara M (2016) The relationship between tinnitus and vascular anomalies on temporal bone CT scan: a retrospective case control study. Surg Radiol Anat 38(7):1–7. CrossRefGoogle Scholar
  12. 12.
    Lee DH, Jun BC, Kim DG, Jung MK, Yeo SW (2005) Volume variation of mastoid pneumatization in different age groups: a study by three-dimensional reconstruction based on computed tomography images. Surg Radiol Anat 27(1):37–42. CrossRefPubMedGoogle Scholar
  13. 13.
    Mohan C, Sharma S, Srivastava A (2015) Has mastoid pneumatization any bearing on tympanoplasty? Indian J Otol 21(4):266–269. CrossRefGoogle Scholar
  14. 14.
    Schillinger R (1939) Pneumatization of the mastoid. Radiology 33:54–67. CrossRefGoogle Scholar
  15. 15.
    Singh V, Chaitanya DK, Chauhan BKS, Kumar IDV (2017) A comparative study of pneumatization of temporal bone. J Anat Soc India 66:78–81. CrossRefGoogle Scholar
  16. 16.
    Song SW, Jun BC, Kim H, Cho Y (2017) Evaluation of temporal bone pneumatization with growth using 3d reconstructed image of computed tomography. Auris Nasus Larynx 44(5):522–527. CrossRefPubMedGoogle Scholar
  17. 17.
    Sözen E, Çelebi I, Uçal YO, Coşkun BU (2013) Is there a relationship between subjective pulsatile tinnitus and petrous bone pneumatization? J Craniofac Surg 24(2):461–463. CrossRefPubMedGoogle Scholar
  18. 18.
    Yegin Y, Çelik M, Şimşek BM, Olgun B, Karahasanoğlu A, Çolak C, Kayhan FT (2016) Correlation between the degree of the mastoid pneumatization and the angle and the length of the eustachian tube. J Craniofac Surg 27(8):2088–2091. CrossRefPubMedGoogle Scholar
  19. 19.
    Zollikofer CP, Weissmann JD (2008) A morphogenetic model of cranial pneumatization based on the invasive tissue hypothesis. Anat Rec 291(11):1446–1454. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Capital Medical University Affiliated Beijing Friendship HospitalBeijingChina

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