Pneumatization Pattern and Status of the Mastoid Antrum in Chronic Otitis Media: A Review

Abstract

Chronic otitis media is generally more prevalent in individuals with a weakly pneumatized temporal bone, whereas acute otitis media has a propensity for pneumatized temporal bone. Antimicrobial drugs are thought to have influenced the incidence and progression of middle ear infections. The mastoid air cell system, a part of the middle ear cleft, has recently been recognized as a crucial factor in the genesis, behaviour, course, and outcome of middle ear inflammatory conditions. Epithelium infiltrates the growing bone and produces epithelium-lined air cell chambers, a process known as pneumatization. Conventional temporal bone radiography, i.e. X-ray mastoid, has not kept up with recent otology breakthroughs. Detailed visualization of the aural structures has advanced significantly with the introduction of high-resolution computed tomography (HRCT). HRCT has a clear edge in the assessment of the temporal bone, especially when thin-section, high-resolution methods are used, resulting in a more precise description of the pneumatization pattern and the anatomical extent of middle ear pathology. Our results of the review indicated that persistent inflammation of the middle ear in children inhibits pneumatization of the temporal bone. Due to its potential to exert a greater negative middle ear pressure, the middle ear volume is insufficient to generate a retraction pocket; thus, the size and state of the antrum is also a significant factor in the establishment of a COM-like retraction pocket in inactive squamosal disease. Numerous factors, including the number of patients, regional, genetic, ethnic and hereditary characteristics, as well as the cellularity of the mastoid, which is impacted by a multitude of factors, may account for the variable reports and inter-study variation in this regard.