Is There Any Analogy Between the Defect of the Eardrum in Chronic Otitis Media and Defect of the Fontanel (Two Holes Syndrome) in Chronic Maxillary Sinusitis

There is a great analogy between the defect of the eardrum in chronic otitis media and defect of the fontanel, the so-called Two Holes Syndrome (THS), which is just one of the forms of the chronic maxillary sinusitis! One should know that when speaking of maxillary sinus and the middle ear as cavities inside human organism, it goes for the same specific “volcanoes,” constantly threatening with their possible eruption. Just a few words regarding the term “accessory ostium”: the adjective “accessory” implies something that stays nearby, for any case, to be of a help if needed, something that could be considered as “additional,” almost being physiological. But, the “accessory ostium” we are talking about in cases with obvious defect of the fontanel should not be considered as an additional ostium simply because it is not the ostium. It is a defect of the fontanel, i.e., the same story as the defect of the eardrum in cases of chronic otitis media. It does not help the maxillary sinus in any way, so there is no reason to name this anatomical entity as “accessory ostium.” So, what are the consequences of having two openings on the lateral nasal wall instead of one natural maxillary sinus ostium? The consequence is so-called Two Holes Syndrome (THS).