MORPHOLOGICAL VARIATIONS OF TEMPORAL BONE PNEUMATIZATION IN CHRONIC OTITIS MEDIA

Abstract

Chronic otitis media is a disease affecting middle ear of the patient. In this disease, fluid accumulation causes erosion of middle ear ossicles and surrounding structures including sigmoid sinus, jugular bulb and height of tegmen tympani. There is also non intact tympanic membrane. Since middle ear is present in temporal bone therefore temporal bone analysis is being done by using plain radiographs, multidirectional tomography, MRI, CT and angiography to analyze degree of effected pneumatization in the patient. Anatomical variations are quite common in the region of temporal bone which can lead to complexity while performing ear and neurologic surgeries. Temporal bone pneumatization is a factor that has been postulated to effect morphology of the structures related to temporal region. Sigmoid sinus is used as a reference for the evaluation of degree of pneumatization of the mastoid bone. Knowledge of sigmoid sinus as well as jugular bulb is important for a surgeon during mastoid surgery. The prevalence of chronic otitis media is around 72 cases per 1000 people in developing countries according to WHO, Khan et al and Ali Zaidi SS et al. Chronic otitis media (COM) can affect the pneumatization and morphology of various structures in temporal region. Our aim was to identify the association between COM and temporal bone pneumatization in normal and diseased ear with chronic otitis media. Human subjects from 10 to 75 years of age with unilateral diseased ear (chronic otitis media) along with opposite normal ear without any pathology, abnormality or fracture were enrolled in the study. Measurements were done on Vitrea Software and readings were noted on subject evaluation form. Different degrees of pneumatization were seen in patients with unilateral COM and there was male dominancy in our study and Punjabi population was most likely reported. The study found an association between the degree of pneumatization and COM as the disease causes ear cells to collapse as a result the cells come close to each other due to fluid accumulation and aeration is lost which increases the risk of fracture. The mean age of the patients was 40.96±15.613 years and Right viii COM was most likely present in the individuals. No association between gender, ethnicity, pus, occupation, pain, discharge, bleeding, and swelling, vertigo and hearing loss was found with Right COM. However the patients reported with pain mainly in case of Right COM. No significant association between gender, ethnicity, pus, discharge, swelling, vertigo and hearing loss was found though found significant association between pneumatization and left COM and bleeding. The majority of the people were doing private job followed by housewives. SPSS 23 was used and Chi square/ Fisher exact test was applied