Pottam Anupama, Dharmana Lavanya, Ajit Damera, Ramakrishna B Badari, Vaddeswarapu Rahul Marshal, Lokesh K V
Department of Oral Medicine and Radiology, Anil Neerukonda Institute of Dental Sciences, Visakhapatnam, IND.
Department of Dentistry, Andhra Medical College, Visakhapatnam, IND.
Cureus. 2023 May 15;15(5):e39040. doi: 10.7759/cureus.39040. eCollection 2023 May.
Oral submucous fibrosis (OSMF) is a potentially premalignant disorder affecting the oral cavity and its adjacent structures. The present study was aimed at a comparative evaluation of eustachian tube (ET) changes in OSMF patients using audiometry and cone-beam computed tomography (CBCT). A total of 40 patients who were clinically diagnosed with OSMF were taken for the study and were graded into clinical and functional staging. After grading, the patients were subjected to audiometry to evaluate their hearing deficit. Subsequently, the patients were subjected to CBCT analysis for the evaluation of the length and volume of the ET. The length of ET was measured in the axial sections of the full-face CBCT images taken at the level of the root tip of the upper first molar. The radiolucency from the nasopharyngeal opening to the maximum distance was considered. The volume of ET was measured using third-party software (ITK-SNAP) in the radiolucent area. The age group in which a higher number of OSMF cases were seen was between 41 and 50 years. There was mild to moderate hearing loss observed in the right and/or left ear, with little variation between right and left ear changes in audiometry. The CBCT analysis did not show a significant difference in the mean length of the eustachian tube when comparing OSMF cases with normal. However, as the disease worsened, the length on the right and left sides significantly decreased. Additionally, there was no statistically significant difference in the mean eustachian tube volume between disease cases and controls. According to the clinical subgrades, the overall volume decreased from lower grade to higher grade, but there was no discernible difference between the left and right ear. The volume on function sub-grading between the right and left ear, however, was significantly reduced. Thus, the length and volume of ET decreased as the disease severity increased, but the mild to moderate hearing loss found in different clinical and functional grades of OSMF cases was not statistically significant. Therefore, from the present study, it can be concluded that all OSMF cases should be evaluated for hearing deficit, and imaging of the eustachian tube should be part of the OSMF assessment for morphological changes of the ET that may cause hearing deficit.
口腔黏膜下纤维化（OSMF）是一种可能发展为恶性病变的疾病，影响口腔及其相邻结构。本研究旨在通过听力测定和锥形束计算机断层扫描（CBCT）对OSMF患者的咽鼓管（ET）变化进行比较评估。共有40例临床诊断为OSMF的患者纳入本研究，并进行临床和功能分期。分期后，对患者进行听力测定以评估其听力缺陷。随后，对患者进行CBCT分析，以评估ET的长度和体积。ET的长度在全脸CBCT图像的轴位切片上测量，该切片位于上颌第一磨牙根尖水平。考虑从鼻咽开口到最大距离的透光区。ET的体积使用第三方软件（ITK-SNAP）在透光区内测量。OSMF病例数量较多的年龄组在41至50岁之间。在右耳和/或左耳观察到轻度至中度听力损失，听力测定中左右耳变化之间差异不大。与正常情况相比，CBCT分析显示OSMF病例的咽鼓管平均长度无显著差异。然而，随着疾病进展，左右两侧的长度显著缩短。此外，病例组和对照组的咽鼓管平均体积无统计学显著差异。根据临床亚级，总体积从低级别到高级别逐渐减小，但左右耳之间无明显差异。然而，在功能亚级中，左右耳的体积显著减小。因此，随着疾病严重程度增加，ET的长度和体积减小，但在不同临床和功能级别的OSMF病例中发现的轻度至中度听力损失无统计学显著差异。因此，从本研究可以得出结论，所有OSMF病例均应评估听力缺陷，并且咽鼓管成像应作为OSMF评估的一部分，以检查可能导致听力缺陷的ET形态变化。
