• Rafael da Costa Monsanto, Henrique Furlan Pauna, Serdar Kaya, Ömer Hızlı, Geeyoun Kwon, Michael M Paparella, and Sebahattin Cureoglu.
• Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
• Laryngoscope. 2016 Nov 1; 126 (11): E369-E374.

Objectives/HypothesisTo compare the volume of the epitympanic space, as well as the area of the tympanic isthmus, in human temporal bones with retraction pockets to those with chronic otitis media without retraction pockets and to those with neither condition.Study DesignComparative human temporal bone study.MethodsWe generated a three-dimensional model of the bony epitympanum and measured the epitympanic space. We also compared the area of the tympanic isthmus.ResultsThe mean total volume of the epitympanum was 40.55 ± 7.14 mm3 in the retraction pocket group, 50.03 ± 8.49 mm3 in the chronic otitis media group, and 48.03 ± 9.16 mm3 in the neither condition group. The mean volume of the anterior, lateral, and medial compartments in temporal bones in the retraction pocket group was significantly smaller than in the two control groups (P < 0.05). Total epitympanic volume was also significantly smaller in the retraction pocket group than in both control groups (P < 0.05). The mean area of the tympanic isthmus was significantly smaller in the retraction pocket group (8.11 ± 2.44 mm2 ) than in the chronic otitis media group (9.82 ± 2.06 mm2 ) or the neither condition group (10.66 ± 1.78 mm2 ) (P < 0.05).ConclusionOur data indicate that temporal bones with retraction pockets have a smaller volume bony epitympanum and a smaller tympanic isthmus area as compared with temporal bones from both control groups. The smaller volume tympanic isthmus in the retraction pocket group may suggest that a blockage in the aeration pathways to the epitympanum could create dysventilation, resulting in negative pressure and ultimately in retraction pockets and cholesteatomas.Level Of EvidenceNA Laryngoscope, 126:E369-E374, 2016.© 2016 The American Laryngological, Rhinological and Otological Society, Inc.

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