Quantification of Mastoid Air Cells and Opacification of the Middle Ear in Primary Ciliary Dyskinesia.

OBJECTIVE

To evaluate pneumatization and opacification of the temporal bone on computed tomography (CT) images in patients with primary ciliary dyskinesia (PCD).

STUDY

DESIGN

Retrospective case-control study.

SETTING

Tertiary referral center.

PATIENTS: Fifteen patients with PCD (30 ears) and 45 age-matched individuals without PCD (90 ears) as controls.

INTERVENTION: Diagnostic only.

MAIN OUTCOME MEASURES: Quantification of mastoid air cells in the PCD and control groups and comparison between them. Degree of middle ear opacification on CT images of the temporal bone in the PCD group.

RESULTS

The volume of the mastoid air cells was 30% smaller in the PCD group than in the control group ( p < 0.05). The suppression ratio, which is defined to indicate how much the average volume of mastoid air cells in the PCD group is suppressed relative to the control group, was 64% lower in the PCD group ( p < 0.05). Opacification was noted in 47% of the mastoid air cells and 63% of the tympanic cavity on CT images of the temporal bone in the PCD group, which were significantly higher frequencies than in the control group (1.1% and 1.1%, respectively).

CONCLUSIONS

Compared with individuals without PCD, those with PCD showed a significantly smaller volume of mastoid air cells and a significantly higher frequency of opacification of mastoid air cells and tympanic cavity on temporal bone CT. Otitis media raises suspicion for PCD, and the otological manifestations of PCD reported here could help to narrow the differential diagnosis and facilitate early treatment.