Udagatti Vithal D, Dinesh Kumar Rajendran, Kumbar Vishwanath, John Krithi P
N.R.M ENT Hospital, Near Mahila Samaj, Raichur, Karnataka 584101 India.
Assistant Professor, Dr. M.G.R. Educational and Research Institute, Rajarajeswari Medical College and Hospital, Department of ENT and Head-Neck Surgery, Bengaluru, Karnataka 560074 India.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5386-5392. doi: 10.1007/s12070-024-04984-2. Epub 2024 Aug 24.
Eustachian tube is complex and inaccessible structure. It connects nasopharynx to middle ear. It is composed of cartilaginous and bony segments. Eustachian tube helps in pressure regulation, protection and clearance of the middle ear. Dysfunctions of Eustachian tube are either due to anatomical obstruction or functional failure. Whether variation of length, width of bony canal, isthmus, length of the cartilaginous canal and angulation of the Eustachian tube to horizontal plane affects overall pressure regulation, protection and mucociliary clearance leads to the spread of the infection to the middle ear are highlighted. A comparative prospective study design of 20 adults of both gender of normal ear computerized tomography done for some other cause and 20 adults of both gender with chronic otitis media (tubo-tympanic pathology). After obtaining consent, clinical examination, all patients had got computerized tomography study of the temporal bone and were evaluated to study the variation of length, width of bony canal, isthmus, length of the cartilaginous canal and angulation of the Eustachian tube to horizontal plane. In our series cartilaginous Eustachian tube length is 26.72 mm in normal ear and 26.17 mm in diseased ear. Long and reduced diameter of bony segment is the anatomical cause in the tubotympanic pathology along with inflammation and loss of ciliary moment. Normal ear bony width is 2.36 mm; isthmus 1.18 mm are comparatively more than diseased ear (bony width 2.13 & isthumus1.04). Whereas bony length of normal ear is 11.21 mm and diseased ear is 11.62 mm. Decreased Eustachian tube pretympanic diameter and Reid -plane ET angle can be used to predict Eustachian tube dysfunction. Angle to horizontal plane in our series in normal ear 44.670 whereas in diseased ear 45.10. The Eustachian tube plays an important role in the development of the tubotympanic pathology of the ear. Pre-existing Eustachian tube anatomical variation appears to be risk factor in developing tubotympanic pathology.
咽鼓管是一个复杂且难以触及的结构。它将鼻咽部与中耳相连。它由软骨段和骨段组成。咽鼓管有助于中耳的压力调节、保护和清理。咽鼓管功能障碍要么是由于解剖学阻塞，要么是由于功能衰竭。咽鼓管骨管的长度、宽度、峡部、软骨管的长度以及咽鼓管与水平面的角度变化是否会影响整体压力调节、保护和黏液纤毛清除，进而导致感染扩散至中耳，这些问题受到了关注。对20名因其他原因进行正常耳部计算机断层扫描的成年男女和20名患有慢性中耳炎（鼓室管型病变）的成年男女进行了一项比较性前瞻性研究设计。在获得同意后，进行临床检查，所有患者均接受了颞骨计算机断层扫描研究，并对咽鼓管骨管的长度、宽度、峡部、软骨管的长度以及咽鼓管与水平面的角度变化进行了评估。在我们的研究系列中，正常耳的软骨性咽鼓管长度为26.72毫米，患病耳为26.17毫米。骨段长且直径减小是鼓室管型病变的解剖学原因，同时伴有炎症和纤毛运动丧失。正常耳的骨宽度为2.36毫米；峡部为1.18毫米，相比患病耳（骨宽度2.13毫米和峡部1.04毫米）要更宽一些。而正常耳的骨长度为11.21毫米，患病耳为11.62毫米。咽鼓管鼓室前直径减小和里德平面咽鼓管角度可用于预测咽鼓管功能障碍。在我们的研究系列中，正常耳与水平面的角度为44.67°，而患病耳为45.1°。咽鼓管在耳部鼓室管型病变的发展中起重要作用。先前存在的咽鼓管解剖变异似乎是发生鼓室管型病变的危险因素。
