Chronic otitis media and middle ear variants: Is there relation?

World J Clin Cases. 2023 May 26;11(15):3481-3490. doi: 10.12998/wjcc.v11.i15.3481.

Abstract

Background: Chronic otitis media (COM) is an inflammatory disease that lasts for a long time. It is common in developing countries. Hearing loss can result from COM. The relationship between variations in middle ear anatomy and COM was investigated in our study.

Aim: To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals.

Methods: This retrospective study included 500 patients with COM and 500 healthy controls. The presence of those variants was determined: Koerner's septum, facial canal dehiscence, high jugular bulb, jugular bulb dehiscence, jugular bulb diverticulum, sigmoid sinus anterior location and deep tympanic recesses.

Results: A total of 1000 temporal bones were examined. The incidences of these variants were respectively (15.4%-18.6%), (38.6%-41.2%), (18.2%-4.6%), (2.6%-1.2%), (1.2%-0%), (8.6%-0%), (0%-0%). It was observed that only high jugular bulb (P < 0.001) and anteriorly located sigmoid sinus frequencies (P = 0.002) in the case group were statistically significantly higher than the control groups.

Conclusion: COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease. We didn't find a positive correlation between COM and Koerner's septum and facial canal defect. We ended up with a significant conclusion with the variants of dural venous sinuses -high jugular bulb, dehiscence of jugular bulb, diverticulum of jugular bulb and anteriorly located sigmoid sinus- that have been studied less and frequently associated with inner ear illnesses.

Keywords: Chronic otitis media; Head and neck; Hearing loss; Inflammation; Mastoid cells; Radiology.