Eustachian Tube Anatomical Variations and Their Contribution to Chronic Suppurative Otitis Media Without Cholesteatoma

Ahmad Yasin, Dewi Pratiwi, Rahmi Fauziyah Rahayu

Abstract

Introduction: Anatomical variations in the Eustachian tube (ET) are known to contribute to ET dysfunction, which plays a significant role in the development and persistence of chronic suppurative otitis media (CSOM). Evaluating ET remains a challenge due to its complex anatomy and location. Our study aim to investigate the relationship of anatomical variations of ET with the risk of developing CSOM without cholesteatoma

Methods: A retrospective, cross-sectional study was conducted using the data from the ORL-HNS Department of Dr. Moewardi hospital. The HRCT scans were performed in the Department of Radiology at the same institution between January 2024 and March 2025. The measurements of Tubotympanic Angle (TTA), Pretympanic Diameter (PTD), Eustachian Tube Angle (ETA), and Eustachian Tube Length (ETL), were performed by an experienced radiologists familiar with temporal bone imaging. Paired and independent T-Tests were applied for analyzing the relationship between variables and the significance was set at p < 0.05.

Results: Thirty patients were included in this study, ranging from 18 to 70 years old. Statistically significant differences were observed between the affected and unaffected ears in terms of TTA, PTD, and ETA. The affected ear had greater TTA value, shorter PTD and smaller ETA values as compared to the unaffected ear (p < 0.001).

Conclusion: Anatomical variations of ET, particularly TTA, PTD, and ETA, contribute to an increased risk of CSOM, suggest that ET anatomy measurement may be beneficial for managing CSOM.

Keywords

chronic suppurative otitis media without cholesteatoma; eustachian tube; tubotympanic angle; pretympanic diameter; eustachian tube angle

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DOI: https://doi.org/10.13057/smj.v9i1.116521

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