[Principles of age-related changes in the surgical approach to the antrum]

The present authors maintain that the surgical approach to the antrum via the mastoid bone as a method of treating chronic purulent otitis media is very promising because it saves bone conduction structures of the middle ear. In order to provide accurate and safe dissection of the antrum, the authors measured the angle between the external auditory meatus and the horizontal skull plane. As they have previously demonstrated, this angle is correlated with the antrum displacement upwards or downwards. On the basis of over 500 observations, the authors have concluded that the angle increases on the average from 13 degrees to 25 degrees at the age of 5 to 40 years and then decreases, reaching 18 degrees by the age of 70 years. The authors recommend to measure the surgical angle for all types of antrotomic intervention, using contrast X-ray ++ of the auditory meatus in the normal anterior projection of the skull.