The “Pathologic Size” of the Mastoid air Cell System

Abstract

A survey presenting the anatomic and the pathologic size variation theories for the pneumatization of the mastoid air cell system and its size variation in the population is given. It shows the fundamental prerequisites for the two controversial theories. The inadmissability of claiming a gradual decrease of a size previously existing as caused by a productive mastoiditis is illuminated.

A destructive or productive and obliterating mastoiditis cannot be claimed to cause a gradual narrowing of the size of the mastoid air cell system. Such a theory cannot be supported by conclusions of analogy between the obliteration of the bulla of the ear in the guinea pig in experimental studies of induced infections and the effect of a mastoiditis in the human ear. In the bulla we are dealing with one single air cell, whereas in the mastoid we have quite a number of communicating air cells. In addition, the bulla experiment must show signs of the infectious productive and obliterating process both on the X-ray and histologically. The size varying mastoid air cell system is not showing any such signs either at the peripheral border or in the area of the air cell system itself, and no trace of the assumed previous existence of an otitis media can be seen in the drum membrane, in the middle ear or in the audiogram.