Section: 
Otiology
OtiologyImpairment of middle ear pneumatization on computed tomography in patients on prolonged mechanical ventilation: temporal dynamics
A. E. Golovanov (1), A. V. Eshenko (2), A. Ya. Latysheva (3), D. D. Styazhkin (4), I. S. Tkachenko (5)
(1), (2), (3), (4), (5) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation, (1) Saint Petersburg Scientific Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.284-003.2-073.756.8:615.816.2
DOI: https://doi.org/10.18692/1810-4800-2026-3-71-80
ABSTRACT
Abstract. Introduction. The increasing number of young patients requiring mechanical ventilation (MV) is attributed to novel pathogens, polytrauma, and severe pathologies, and is accompanied by a high risk of otorhinolaryngological complications. Impairment of pneumatization across all anatomical compartments of the middle ear during prolonged MV, systematically detected via multislice computed tomography (MSCT) of the brain and facial skull, ranges from 10% to 80% according to the literature. The key pathogenetic mechanism is dysfunction of the Eustachian tube, induced by disruption of the nasal cycle and the pharyngeal phase of deglutition, leading to the accumulation of exudate in the air-containing cavities of the middle ear and subsequent risk of otogenic complications. Aim. To assess the temporal dynamics of impaired pneumatization of middle ear structures using MSCT in mechanically ventilated patients. Patients and Methods. A prospective analysis of 183 MSCT scans of the brain and facial skull (with emphasis on the temporal bones) was performed in MV patients (Day 3/Day 7). Assessment was based on the degree of middle ear opacification, laterality of the process, and duration of MV. Statistical analysis was performed using McNemar's test and Fisher's exact test (Holm correction) in Jamovi software. Results. By day 3 of mechanical ventilation, impaired middle ear aeration was observed in 33.8% of patients. By day 7, this rate increased to 98.3%. There was a predominance of subtotal and total forms of involvement, which collectively accounted for 75.96% (n = 139) of patients (p < 0.001). Conclusion. Prolonged MV statistically significantly induces progressive impairment of middle ear aeration, with a shift from early unilateral disturbances to subtotal and total involvement.
Publication date:
16.06.2026
Keywords:
middle ear, оtitis media, otitis media with effusion, middle ear effusion (MEE), middle ear opacification, impaired middle ear aeration, mechanical ventilation, multislice computed tomography in otorhinolaryngology For citation:
Golovanov A. E., Eshenko A. V., Latysheva A. Ya., Styazhkin D. D., Tkachenko I. S. Impairment of middle ear pneumatization on computed tomography in patients on prolonged mechanical ventilation: temporal dynamics. Russian Otorhinolaryngology. 2026;25(3):71-80. (In Russ.) https://doi.org/10.18692/1810-4800-2026-3-71-80