A Structural Analysis of Tympanic Compartments of the Middle Ear in Patients With Down's Syndrome: A Temporal Bone Study.


Journal

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
ISSN: 1537-4505
Titre abrégé: Otol Neurotol
Pays: United States
ID NLM: 100961504

Informations de publication

Date de publication:
09 2020
Historique:
pubmed: 23 6 2020
medline: 15 4 2021
entrez: 23 6 2020
Statut: ppublish

Résumé

: Hypothesis: There may be findings peculiar to the temporal bones of children with Down's syndrome (DS). The purpose of this study is to investigate the temporal bone histopathology of the children with DS. Otitis media with effusion is a highly prevalent condition with DS. Knowledge of the volume of the tympanic compartments and the area of the tympanic isthmus might be important to find out the pathogenesis of highly prevalent otitis media with effusion in those patients. We compared the volume of the epitympanum, mesotympanum, and the areas of the tympanic isthmus and tympanic orifice of eustachian tube in temporal bones from patients with DS. We also investigated the eustachian tube histopathologically. The mean volume of the epitympanum and the mesotympanum was significantly smaller in the DS group than the control group. We found no significant difference in the mean diameter of the protympanic opening and tympanic orifice between the two groups. The mean narrowest area of the aerated and bony tympanic isthmus also was not significantly different between the two groups. An immature development of eustachian tube and cartilage was seen. We found mesenchyme remaining at the epitympanum and/or mesotympanum in all specimens in the DS group, and in five specimens in the control group. In the presence of the small middle ear, poorly developed eustachian tube, and tensor muscle, a vicious circle occurs, making otitis media with effusion difficult to resolve.

Sections du résumé

: Hypothesis: There may be findings peculiar to the temporal bones of children with Down's syndrome (DS). The purpose of this study is to investigate the temporal bone histopathology of the children with DS.
BACKGROUND
Otitis media with effusion is a highly prevalent condition with DS. Knowledge of the volume of the tympanic compartments and the area of the tympanic isthmus might be important to find out the pathogenesis of highly prevalent otitis media with effusion in those patients.
METHODS
We compared the volume of the epitympanum, mesotympanum, and the areas of the tympanic isthmus and tympanic orifice of eustachian tube in temporal bones from patients with DS. We also investigated the eustachian tube histopathologically.
RESULTS
The mean volume of the epitympanum and the mesotympanum was significantly smaller in the DS group than the control group. We found no significant difference in the mean diameter of the protympanic opening and tympanic orifice between the two groups. The mean narrowest area of the aerated and bony tympanic isthmus also was not significantly different between the two groups. An immature development of eustachian tube and cartilage was seen. We found mesenchyme remaining at the epitympanum and/or mesotympanum in all specimens in the DS group, and in five specimens in the control group.
CONCLUSION
In the presence of the small middle ear, poorly developed eustachian tube, and tensor muscle, a vicious circle occurs, making otitis media with effusion difficult to resolve.

Identifiants

pubmed: 32569132
doi: 10.1097/MAO.0000000000002715
pii: 00129492-202009000-00033
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1149-1157

Références

Centers for Disease Control and Prevention (CDC)Down syndrome prevalence at birth: United States, 1983-1990. MMWR Morb Mortal Wkly Rep 1994; 43:617–622.
Schwarts DM, Schwarts RH. Acoustic impedance and otoscopic findings in young children with Down's syndrome. Arch Otolaryngol 1978; 104:652–656.
Barr E, Dungworth J, Hunter K, et al. The prevalence of ear, nose and throat disorders in preschool children with Down's syndrome in Glasgow. Scott Med J 2011; 56:98–103.
Maris M, Wojciechowski M, Van de Heyning P, et al. A cross-sectional analysis of otitis media with effusion in children with Down syndrome. Eur J Pediatr 2014; 173:1319–1325.
Rodman R, Pine HS. The otolaryngologist's approach to the patient with Down syndrome. Otolaryngol Clin N Am 2012; 45:599–629.
Balkany TJ, Downs MP, Jafec BW, et al. Hearing loss in Down's syndrome. A treatable handicap more common than generally recognized. Clin Pedeatr 1979; 18:116–118.
Shott SR. Down syndrome: common otolaryngologic manifestation. Am J Med Genet C Semin Med Genet 2006; 142C:131–140.
Ishii M, Igarashi M, Jenkins HA. Volumetric analysis of the tympanic isthmus in human temporal bones. Arch Otolaryngol Head Neck Surg 1987; 113:401–404.
Shirai K, Schachern PA, Schachern MG, Paparella MM, Cureoglu S. Volume of the epitympanum and blockage of tympanic isthmus in chronic otitis media: A human temporal bone study. Otol Neurotol 2015; 36:254–259.
Monsanto RC, Pauna HF, Kaya S, et al. Epitympanum volume and tympanic isthmus area in temporal bones with retraction pockets. Laryngoscope 2016; 126:E369–E374.
Azuma T, Nogaki T, Schachern P, Paparella MM, Cureoglu S. Structural analysis of tenser tympani muscle, tympanic diaphragm, epitympanum, and protympanum in Menière's disease: A human temporal bone study. Otol Neurol 2018; 39:499–505.
Palva T, Johnsson LG. Epitympanic compartment surgical considerations: Reevaluation. Am J Otol 1995; 16:505–513.
Glass RB, Yousefzadeh DK, Roizen NJ. Mastoid abnormalities in Down syndrome. Pediatr Radiol 1989; 19:311–312.
Shinnabe A, Yamamoto H, Hara M, et al. A comparison of preoperative characteristics of chronic otitis media in Down and non-Down syndrome. Otol Neurotol 2014; 35:972–975.
Cinamon U, Sadé J. Mastoid and tympanic membrane as pressure buffers: A quantitative study in a middle ear cleft model. Otol Neurotol 2003; 24:839–842.
Padurariu S, de Greef D, Jakobsen H, et al. Pressure buffering by the tympanic membrane. In vivo measurements of middle ear pressure fluctuations during elevator motion. Hear Res 2016; 340:113–120.
Shibahara Y, Sando I. Congenital anomalies of the Eustachian tube in Down syndrome. Histopathologic case report. Ann Otol Rhinol Laryngol 1989; 98:543–547.
Pauna HF, Monsato RC, Schachern P, Paparella MM, Chole RA, Cureoglu S. Evidence against the mucosal traction theory in cholesteatoma. Laryngoscope 2018; 128:1663–1667.
Yamaguchi N, Sando I, Harada Y, et al. Histologic study of eustachian tube cartilage with and without congenital anomalies: A preliminary study. Ann Otol Rhinol Laryngol 1990; 99:984–987.
Chatellier HP, Lemoine J. Le diaphragm inter-attico-tympanique du nouveaune. Ann Otolaryngol Chir Cervico-Fac (Paris) 1946; 13:534–566.
Palva T, Ramsay H. Incudal folds and epitympanic aeration. Am J Otol 1996; 17:700–708.
Palva T, Ramsay H, Bohling T. Tensor fold and anterior epitympanum. Am J Otol 1997; 18:307–316.
Marchioni L, Alicandri-Ciufelli M, Molteni G, Artioli FL, Genovese E, Presutti L. Selective epitympanic dysventilation syndrome. Laryngoscope 2010; 120:1028–1033.
Takahara T, Sando I, Hashida Y, et al. Mesenchyme remaining in human temporal bones. Otolaryngol Head Neck Surg 1986; 95:349–357.
Takahara T, Sando I. Mesenchyme remaining in temporal bones from patients with congenital anomalies. A quantitative histopathologic study. Ann Otol Rhinol Laryngol 1987; 96:333–339.

Auteurs

Taketoshi Nogaki (T)

Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Otolaryngology, Showa University School of Medicine, Tokyo, Japan.

Michael M Paparella (MM)

Paparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA.

Sebahattin Cureoglu (S)

Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

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