Adolescent ; Child ; Cleft Palate ; pathology ; Eustachian Tube ; anatomy & histology ; pathology ; Female ; Humans ; Male ; Nasopharynx ; anatomy & histology ; pathology ; Young Adult

The purpose of this study was to describe the luminal development of the murine eustachian tube and middle ear. Thirty specimens, aging from gestational day 11 to postnatal day 21, were investigated through the light microscopic observations. The present study also used digitizer, computer, and serially sectioned temporal bone specimens for three-dimensional reconstruction to measure the volume of the eustachian tube and middle ear cavity at different gestational and postnatal ages. The first pharyngeal pouch elongated during gestational day 12 to form the tubotympanic recess. Between gestational day 13 and 14 this tubotympanic recess extended to the middle ear area. A rapid increment in the volume of the tubotympanic recess was noted between gestational day 15 and 16. At this age, a definite division of the tubotympanic recess into the eustachian tube and middle ear cavity was observed. During the postnatal period, the maximum change of the middle ear volume was noted on postnatal day 11 when the mesenchymal tissue in the middle ear cavity disappeared completely.
Animal ; Ear, Middle/anatomy & histology/*embryology/growth & development ; Eustachian Tube/anatomy & histology/*embryology/growth & development ; Female ; Male ; Mice ; Mice, Inbred BALB C ; Pregnancy

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.
Adult ; Ear Canal/anatomy & histology ; Eustachian Tube/physiology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/classification/*diagnosis ; Tomography, Optical Coherence/instrumentation/*methods ; Tympanic Membrane/*physiology

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.
Adult ; Ear Canal/anatomy & histology ; Eustachian Tube/physiology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media/classification/*diagnosis ; Tomography, Optical Coherence/instrumentation/*methods ; Tympanic Membrane/*physiology

OBJECTIVE: To observe the morphological alterations in pharyngeal ostium of Eustachian tube and its surrounding tissues and its correlation with secretory otitis media. METHOD: 72 volunteers (144 ears) as control group, 89 patients (151 ears) as SOM group, all were observed for the shape of pharyngeal opening of auditory tube and the morphological changes of its surrounding structures. RESULT: Statistic difference was found between the shape of pharyngeal ostium of eustachian tube of adult patients with SOM and that of control group, but for children, there was no difference. It indicated that there was a difference between adult and children in morphological changes of pharyngeal ostium of eustachian tube when suffered from SOM. CONCLUSION Morphological changes of pharyngeal ostium of eustachian tube play an important role in the genesis and development of adult SOM . The primary change in children patients is the inflammation of nasopharynx, then is the hypertrophy of adenoid and tubal tonsil. Nasopharyngeal-fibroscope is a very useful tool in the diagnosis and treatment of SOM.
Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Eustachian Tube ; anatomy & histology ; pathology ; Humans ; Middle Aged ; Otitis Media with Effusion ; pathology ; Young Adult

OBJECTIVETo identify the landmarks of transpterygoid approach and to report its application in a series of cases.

METHODSTwo silicon-injected adult cadaveric heads(4 sides) were dissected by performing an endoscopic endonasal transpterygoid approach after CT scanning for imaging guidance. High-quality pictures were obtained. This approach was used to treat twelve patients with skull base lesions including 3 spontaneous cerebrospinal fluid (CSF) leaks in the lateral recess of the sphenoid sinus, 2 neurofibromas and 2 Schwannomas involving the pterygopalatine fossa and infratemporal fossa, 1 dermoid cyst involving the middle fossa and infratemporal fossa, 1 invasive fungal sinusitis invading the middle fossa base, 1 basal cell adenoma in the upper parapharyngeal space, 1 chondrosarcoma in the parasellar region and 1 adenoid cystic carcinoma. Clinical records were reviewed.

RESULTSIn terms of approach dissection, important landmarks, such as the sphenopalatine foramen and artery, vidian canal and nerve, foramen rotundum and maxillary branch of trigeminal nerve, foramen ovale and mandibular branch of trigeminal nerve, as well as pterygoid segment of Eustachian tube were identified. In terms of clinical data, three patients with spontaneous CSF leak underwent repair. Six patients with benign lesions underwent complete tumor resection. In the patient with invasive fungal disease, thorough debridement was undertaken and antifungal drug was administered for one month. For these benign skull base lesions, there was no recurrence during the follow-up period. In the patient with chondrosarcoma, most of the tumor was removed in the first operation, and was followed by two endoscopic operations because of fast growth of the tumor. Final control was achieved with chemotherapy and radiation. In the patient with adenoid cystic carcinoma, tumor recurred five years after surgery, and was reoperated.

CONCLUSIONAn understanding of the landmarks of the transpterygoid approach is paramount for surgically dealing with disease located within and adjacent to the region of the pterygoid process of the sphenoid bone. The endoscopic endonasal transpterygoid approach is feasible and safe in selected patients with skull base lesions.

Adult ; Cerebrospinal Fluid Leak ; surgery ; Cranial Fossa, Middle ; pathology ; Dissection ; Endoscopy ; Eustachian Tube ; anatomy & histology ; Humans ; Nasal Cavity ; surgery ; Neoplasm Recurrence, Local ; Orbit ; anatomy & histology ; Otorhinolaryngologic Surgical Procedures ; methods ; Pterygopalatine Fossa ; pathology ; Skull Base ; anatomy & histology ; surgery ; Skull Base Neoplasms ; surgery ; Sphenoid Bone ; anatomy & histology ; Tomography, X-Ray Computed ; Trigeminal Nerve ; anatomy & histology