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Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
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Correction: Sinonasal Clear Cell Carcinoma Masquerading as Recurrent Inverted Papilloma.

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Cog - A Radiological Indicator in Identifying Dysventilation Syndrome.

Pooja K Vasu1, Satish Nair1, J G Aishwarya1

  • 1Department of ENT-HNS, Apollo Hospitals, Bangalore, 560076 Karnataka India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|May 19, 2023
PubMed
Summary

Absent cog is more common in individuals with squamous disease, potentially leading to middle ear dysventilation. This radiological study highlights the link between cog status and anterior epitympanic recess (AER) health.

Keywords:
Anterior epitympanic recessAnterior epitympanumCholesteatomaChronic otitis media squamous diseaseCogDysventilation syndromeTensor tympani fold

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Area of Science:

  • Otolaryngology
  • Radiology
  • Anatomy

Background:

  • The anterior epitympanic recess (AER) is crucial for middle ear ventilation.
  • Dysventilation of the AER can lead to retraction pockets and cholesteatomas.
  • Endoscopic surgery has improved visualization of middle ear mucosal folds and spaces.

Purpose of the Study:

  • To radiologically evaluate the anterior epitympanic recess (AER) and cog.
  • To analyze the association between cog status and dysventilation syndrome.
  • To investigate the role of cog in the pathogenesis of cholesteatoma.

Main Methods:

  • Prospective radiological study of 250 high-resolution CT scans of the temporal bone.
  • 200 normal scans (Group I) and 50 scans with chronic otitis media and squamous disease (Group II).
  • Analysis of AER dimensions and cog status (complete, incomplete, absent).

Main Results:

  • 200 normative temporal bone CT scans showed 133 complete cog, 54 incomplete cog, and 13 absent cog.
  • Mean AER dimensions: AP 4.24±1.3 mm, TD 3.36±1.05 mm, VD 5.3±1.94 mm.
  • In 50 scans with squamous disease, 32 had absent cog.

Conclusions:

  • The incidence of absent cog is significantly higher in individuals with squamous disease compared to normal individuals.
  • Absent cog may lead to a horizontally oriented tensor tympani.
  • This anatomical variation can result in middle ear dysventilation, predisposing to cholesteatoma.