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Pars flaccida retraction and mastoid size: relationship in clinically normal specimens

Published online by Cambridge University Press:  26 February 2007

N W Todd*
Affiliation:
Temporal Bone Laboratory, Emory University, Atlanta, Georgia, USA
*
Address for correspondence: Dr N Wendell Todd, Temporal Bone Laboratory, Emory University, 1365A Clifton Road, Atlanta, Georgia 30322, USA. E-mail: [email protected]

Abstract

Background:

The relationship of pars flaccida retraction with epitympanic aeration and mastoid size is ill-defined. Both pars flaccida retraction and small mastoid size are traits of nearly all clinical entities of otitis media.

Objectives:

To determine, in clinically normal specimens, the relationship of pars flaccida retraction with mastoid pneumatisation and epitympanic aeration.

Study design:

Post-mortem anatomical dissection of 41 bequeathed adult crania without clinical otitis.

Methods:

Pars flaccida retractions were viewed with an operating microscope and judged using Sade's classification. Mastoid sizes were determined radiographically (by plain Law lateral images). Ten crania, five with the largest mastoids and five with the smallest mastoids, were studied by computed tomography.

Results:

No specimen had a retraction worse than Sade grade two (i.e. retracted onto the neck of the malleus). Retractions were unrelated to the extent of mastoid pneumatisation. All epitympani were found to be normal on both anatomical dissection and computed tomography imaging.

Conclusion:

Pars flaccida retraction is probably related to prior, presumably transient, non-aeration of Prussak's space.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented as a poster at the meeting of the Southern Section of the Triological Society, 12–14 January 2006, Naples, Florida, USA.

References

1Sade, J, Fuchs, C, Luntz, M. Shrapnell membrane and mastoid pneumatization. Arch Otolaryngol Head Neck Surg 1997;123:584–8CrossRefGoogle ScholarPubMed
2Luntz, M, Teszler, CB, Shpak, T, Feiglin, H, Farah-Sima'an, A. Cochlear implantation in healthy and otitis-prone children: a prospective study. Laryngoscope 2001;111:1614–18CrossRefGoogle ScholarPubMed
3Kobayashi, T, Toshima, M, Yaginuma, Y, Ishidoya, M, Suetake, M, Takasaka, T. Pathogenesis of attic retraction pocket and cholesteatoma as studied by computed tomography. Am J Otol 1994;15:658–62Google ScholarPubMed
4Todd, NW, Pitts, RB, Braun, IF, Heindel, H. Mastoid size determined with lateral radiographs and computerized tomography. Acta Otolaryngol (Stockh) 1987;103:226–31CrossRefGoogle ScholarPubMed
5Palva, T, Ramsey, H, Northrop, C. Color Atlas of the Anatomy and Pathology of the Epitympanum. Basel: Karger, 2001CrossRefGoogle Scholar
6Larsson, C, von Unge, M, Dirckx, JJ, Decraemer, WF, Bagger-Sjoback, D. Displacement pattern of the normal pars flaccida in the gerbil. Otol Neurotol 2001;22:558–66CrossRefGoogle ScholarPubMed
7Shohet, JA, de Jong, AL. The management of pediatric cholesteatoma. Otolaryngol Clin North Am 2002;35:841–51CrossRefGoogle ScholarPubMed
8MRC Multi-Center Otitis Media Study Group. Pars tensa and pars flaccida retractions in persistent otitis media with effusion. Otol Neurotol 2001;22:291–8CrossRefGoogle Scholar
9Dornelles, C, Costa, SS, Meurer, L, Schweiger, C. Some considerations about acquired adult and pediatric cholesteatomas. Rev Bras Otorrinolaringol (Engl Ed) 2005;71:536–45CrossRefGoogle ScholarPubMed
10Bujia, J, Holly, A, Antoli-Candela, F, Tapia, MG, Kastenbauer, E. Immunobiological peculiarities of cholesteatoma in children: quantification of epithelial proliferation by MIB1. Laryngoscope 1996;106:865–8CrossRefGoogle ScholarPubMed
11Quaranta, A, Resta, L, Santangelo, A. Otomastoid cholesteatoma in children: histopathological findings. Int J Pediatr Otorhinolaryngol 1986;12:121–6CrossRefGoogle ScholarPubMed
12Todd, NW. Association of abnormal appearance of tympanic membrane with minimal temporal bone pneumatization: a cadaver study. ORL J Otorhinolaryngol Relat Spec 1987;49:133–7CrossRefGoogle ScholarPubMed