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

Otolaryngol Head Neck Surg. 2021 Jan;164(1):188-190. doi: 10.1177/0194599820940219. Epub 2020 Jul 14.


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.

Keywords: eustachian tube; eustachian tube dysfunction; physical examination; salpingitis; telehealth; telemedicine; temporomandibular joint dysfunction.

MeSH terms

  • 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
  • Salpingitis
  • Surveys and Questionnaires
  • Telemedicine
  • Tomography, X-Ray Computed