From the Departments of Radiology and Nuclear Medicine (W.L.v.d.M., C.M., A.A.P.)
Otorhinolaryngology and Head and Neck Surgery (M.v.T.), Maastricht University Medical Center, Maastricht, the Netherlands.
AJNR Am J Neuroradiol. 2019 Sep;40(9):1552-1556. doi: 10.3174/ajnr.A6161. Epub 2019 Aug 8.
Necrotizing external otitis is a serious complication of external otitis with different spreading patterns. A persistent foramen of Huschke is a dehiscence located antero-inferior in the osseous external ear canal and posterior-medial to the temporomandibular joint. This dehiscence can facilitate extension of infection in an anterior pattern next to classic spread along the fissures of Santorini. The aim of this study was to define the prevalence and size of a persistent foramen of Huschke in patients with necrotizing external otitis.
We retrospectively examined 78 CT temporal bone studies (39 patients with necrotizing external otitis, 39 control subjects). The side and presence of the foramen were noted, and its prevalence was calculated. The maximal width of the foramen of Huschke was measured in the axial plane and classified as subtle, mild, moderate, or extensive.
A persistent foramen of Huschke was present in 21 patients (26 ears) and 7 control subjects (9 ears). Prevalence was 50% (20/40) and 11.5% (9/78) in affected ears of patients with necrotizing external otitis and control subjects, respectively. Almost all affected ears showed an anterior distribution pattern of necrotizing external otitis. The extensive dehiscence was most common in affected ears.
An anterior necrotizing external otitis spreading pattern is associated with the presence and increased size of a persistent foramen of Huschke. These findings facilitate the theory that a persistent foramen of Huschke is an additional risk factor the development of necrotizing external otitis.
坏死性外耳道炎是外耳道炎的一种严重并发症，其扩散模式不同。Huschke 持续孔位于骨性外耳道的前下和颞下颌关节的后内侧，是一种裂孔。这种裂孔可使感染以沿 Santorini 裂隙的经典扩散方式向前扩散的方式扩散。本研究的目的是确定坏死性外耳道炎患者中 Huschke 持续孔的患病率和大小。
我们回顾性地检查了 78 例 CT 颞骨研究（39 例坏死性外耳道炎患者，39 例对照）。注意孔的位置和存在，并计算其患病率。在轴位平面上测量 Huschke 孔的最大宽度，并将其分为细微、轻度、中度或广泛。
Huschke 持续孔存在于 21 例（26 耳）和 7 例对照（9 耳）中。坏死性外耳道炎患者患耳的患病率为 50%（20/40），对照组为 11.5%（9/78）。几乎所有患耳均表现为坏死性外耳道炎的前分布模式。广泛的裂孔在受累耳中最为常见。
前向坏死性外耳道炎扩散模式与 Huschke 持续孔的存在和增大有关。这些发现支持了 Huschke 持续孔是坏死性外耳道炎发生的另一个危险因素的理论。
