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A 3-D analysis of the protympanum in human temporal bones with chronic ear disease

  • Otology
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Abstract

Eustachian tube dysfunction is believed to be an important factor to cholesteatoma development and recurrence of disease after surgical treatment. Although many studies have described prognostic factors, evaluation methods, or surgical techniques for Eustachian tube dysfunction, they relied on the soft tissues of its structure; little is known about its bony structure—the protympanum—which connects the Eustachian tube to the tympanic cavity, and can also be affected by several inflammatory conditions, both from the middle ear or from the nasopharynx. We studied temporal bones from patients with cholesteatoma, chronic otitis media (with and without retraction pockets), purulent otitis media, and non-diseased ears, looking for differences between the volume of the protympanum, the diameter of the Eustachian tube isthmus, and the distance between the anterior tympanic annulus and the promontory. Light microscopy and 3-D reconstruction software were used for the measurements. We observed a decrease of volume in the lumen of the four middle ear diseased ears compared to the control group. We observed a significant decrease in the volume of the protympanic space in the cholesteatoma group compared to the chronic otitis media group. We also observed a decrease in the bony space (protympanum space) in cholesteatoma, chronic otitis media with retraction pockets, and purulent otitis media compared to the control group. We found a correlation in middle ear diseases and a decrease in the middle ear space. Our findings may suggest that a smaller bony volume in the protympanic area may trigger middle ear dysventilation problems.

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Acknowledgements

This project was funded by NIH NIDCD U24 DC011968, International Hearing Foundation, Starkey Hearing Foundation, and Lions 5 M International.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, 2001 6th Street SE, Lions Research Building Room 210, Minneapolis, MN, 55455, USA

    Henrique F. Pauna, Rafael C. Monsanto, Patricia Schachern, Michael M. Paparella & Sebahattin Cureoglu

  2. Department of Otolaryngology, Head and Neck Surgery, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil

    Henrique F. Pauna

  3. Department of Otolaryngology and Head and Neck Surgery, Banco de Olhos de Sorocaba Hospital (BOS), Sorocaba, São Paulo, Brazil

    Rafael C. Monsanto

  4. Paparella Ear, Head and Neck Institute, Minneapolis, MN, USA

    Michael M. Paparella

Authors
  1. Henrique F. Pauna
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  2. Rafael C. Monsanto
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  3. Patricia Schachern
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  4. Michael M. Paparella
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  5. Sebahattin Cureoglu
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Corresponding author

Correspondence to Sebahattin Cureoglu.

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Funding

This study was funded by NIH NIDCD U24 DC011968, International Hearing Foundation, Starkey Hearing Foundation, and Lions 5 M International.

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None.

Research involving human participants and/or animals

This article does not contain any studies with human participants performed by any of the authors. The Institutional Review Board of the University of Minnesota approved this study (0206M26181).

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Pauna, H.F., Monsanto, R.C., Schachern, P. et al. A 3-D analysis of the protympanum in human temporal bones with chronic ear disease. Eur Arch Otorhinolaryngol 274, 1357–1364 (2017). https://doi.org/10.1007/s00405-016-4396-4

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  • DOI: https://doi.org/10.1007/s00405-016-4396-4

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