Chronic otitis media(COM)is a long-standing inflammatory condition affecting the middle ear and mastoid cavity,often resulting in progressive structural damage and functional deficits.Radiological imaging is fundament...Chronic otitis media(COM)is a long-standing inflammatory condition affecting the middle ear and mastoid cavity,often resulting in progressive structural damage and functional deficits.Radiological imaging is fundamental in diagnosing the disease,assessing its severity,and identifying possible complications.The literature indicates that the prevalence rates of extracranial and intracranial complications range from 0.69% to 5%,while the mortality rate for intracranial complications is 26%.While magnetic resonance imaging is particularly useful in distinguishing soft tissue abnormalities and detecting intracranial extensions like meningitis,brain abscess,and sigmoid sinus thrombosis,highresolution computed tomography remains the preferred modality for evaluating bony erosion,cholesteatoma,and mastoid involvement.Key complications such as ossicular chain destruction,facial nerve damage,and labyrinthine fistulae can be precisely identified using advanced imaging modalities,allowing for timely and effective surgical intervention.This minireview underscores the essential role of radiology in both diagnosing and managing COM,highlighting critical imaging findings that facilitate early detection and inform treatment decisions.A collaborative approach among radiologists,otolaryngologists,and infectious disease specialists is crucial for improving clinical outcomes in affected patients.展开更多
Background Surgical treatments for chronic suppurative and cholesteatoma otitis media have been discussed for several decades, but recurrences still occur because of the complex dissection required and hidden lesions ...Background Surgical treatments for chronic suppurative and cholesteatoma otitis media have been discussed for several decades, but recurrences still occur because of the complex dissection required and hidden lesions associated with otomastoiditis. This study investigated the technology and strategy behind the use of otoendoscopic-assisted otosurgery. Methods We reported on hidden lesions in 32 ears of patients with otomastoiditis between November 2006 and January 2009. All the patients were treated with the aid of an otoendoscope. The advantages of otoendoscopy, including multi-angle light scattering, aperture illumination, and magnification of the local operative field, were utilized in otologic microsurgery, and otoendoscopic operative techniques were introduced for operative sites such as the epitympanum, aditus of the antrum, facial recess, sinus tympani and the mastoid tip. Results All patients were followed up from 3 months to 2 years after surgery. All patients recovered well within 3 months following surgery, except for one case of epithelialization of the mastoid cavity occurring 6 months after surgery for cholesteatoma on the cerebellar surface and another case with Bezold＇s abscess, hyperplastic granulation tissue developed at the antrum. Conclusions Otoendoscopy can overcome the technical deficiency of rectilinearity of the visual axis associated with otomicroscopic illumination, which presents a problem when dealing with otomastoiditis lesions in hidden areas. This technique allows such lesions within the complex three-dimensional structure to be visualized and cleaned. Otoendoscopy thus has significant potential for improving the quality of surgery and reducing the risk of postoperative recu rrence.展开更多
文摘Chronic otitis media(COM)is a long-standing inflammatory condition affecting the middle ear and mastoid cavity,often resulting in progressive structural damage and functional deficits.Radiological imaging is fundamental in diagnosing the disease,assessing its severity,and identifying possible complications.The literature indicates that the prevalence rates of extracranial and intracranial complications range from 0.69% to 5%,while the mortality rate for intracranial complications is 26%.While magnetic resonance imaging is particularly useful in distinguishing soft tissue abnormalities and detecting intracranial extensions like meningitis,brain abscess,and sigmoid sinus thrombosis,highresolution computed tomography remains the preferred modality for evaluating bony erosion,cholesteatoma,and mastoid involvement.Key complications such as ossicular chain destruction,facial nerve damage,and labyrinthine fistulae can be precisely identified using advanced imaging modalities,allowing for timely and effective surgical intervention.This minireview underscores the essential role of radiology in both diagnosing and managing COM,highlighting critical imaging findings that facilitate early detection and inform treatment decisions.A collaborative approach among radiologists,otolaryngologists,and infectious disease specialists is crucial for improving clinical outcomes in affected patients.
文摘Background Surgical treatments for chronic suppurative and cholesteatoma otitis media have been discussed for several decades, but recurrences still occur because of the complex dissection required and hidden lesions associated with otomastoiditis. This study investigated the technology and strategy behind the use of otoendoscopic-assisted otosurgery. Methods We reported on hidden lesions in 32 ears of patients with otomastoiditis between November 2006 and January 2009. All the patients were treated with the aid of an otoendoscope. The advantages of otoendoscopy, including multi-angle light scattering, aperture illumination, and magnification of the local operative field, were utilized in otologic microsurgery, and otoendoscopic operative techniques were introduced for operative sites such as the epitympanum, aditus of the antrum, facial recess, sinus tympani and the mastoid tip. Results All patients were followed up from 3 months to 2 years after surgery. All patients recovered well within 3 months following surgery, except for one case of epithelialization of the mastoid cavity occurring 6 months after surgery for cholesteatoma on the cerebellar surface and another case with Bezold＇s abscess, hyperplastic granulation tissue developed at the antrum. Conclusions Otoendoscopy can overcome the technical deficiency of rectilinearity of the visual axis associated with otomicroscopic illumination, which presents a problem when dealing with otomastoiditis lesions in hidden areas. This technique allows such lesions within the complex three-dimensional structure to be visualized and cleaned. Otoendoscopy thus has significant potential for improving the quality of surgery and reducing the risk of postoperative recu rrence.
