The Infratemporal Fossa Sign: Pilot Study of a Potential Clue to Eustachian Salpingitis

• Published in: Otolaryngology-head and neck surgery Vol. 164; no. 1; p. 188
• Main Author: McCoul, Edward D
• Format: Journal Article
• Language: English
• Published: England 01.01.2021
• Subjects: Acoustic Impedance Tests; Adult; Ear Diseases - diagnosis; Ear Diseases - physiopathology; Endoscopy; Eustachian Tube - diagnostic imaging; Eustachian Tube - physiopathology; Female; Humans; Infratemporal Fossa - anatomy & histology; Infratemporal Fossa - diagnostic imaging; Male; Middle Aged; Otoscopy; Phenotype; Physical Examination; Pilot Projects; Surveys and Questionnaires; Telemedicine; Tomography, X-Ray Computed; telemedicine; eustachian tube dysfunction; temporomandibular joint dysfunction; telehealth; salpingitis; eustachian tube; physical examination
• ISSN: 1097-6817
• DOI: 10.1177/0194599820940219

Aural discomfort may be the result of obstructive eustachian tube (ET) dysfunction, temporomandibular joint dysfunction, or other causes. The infratemporal fossa (ITF) sign, in which a patient points to a characteristic location below the auricle, is proposed as an indicator of nonobstructive eustachian salpingitis. A preliminary study included patients with a complaint of aural discomfort who were prompted to localize symptoms using a single finger. Group 1 localized by using the ITF sign; group 2 localized deep within the external ear canal (suggesting ET dysfunction); and group 3 localized to the preauricular region (suggesting temporomandibular joint dysfunction). Findings of ET inflammation recorded during nasal endoscopy were greater in groups 1 and 2. Tympanometry and otoscopy were uniformly abnormal for group 2 and uniformly normal for groups 1 and 3. The ITF sign may help to identify eustachian salpingitis as a phenotype of ET disease characterized by symptomatic inflammation without abnormal middle ear pressure.