scholarly journals Prospective study on the Eustachian tube function during Frenzel maneuver in a hypobaric/hyperbaric pressure chamber

2021 ◽  
Author(s):  
Philipp Wolber ◽  
Moritz Friedo Meyer ◽  
Kristijana Knesic ◽  
Svenja Rink ◽  
Stefanie Jansen ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Valsalva Maneuver ◽  
Pressure Chamber ◽  
Eustachian Tube Function ◽  
Opening Pressure ◽  
Pressure Equalization ◽  
Hyperbaric Pressure ◽  
Tube Function ◽  
Pressure Dynamics ◽  
Standard Values

Abstract Introduction The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Until now, there is insufficient literature about the pressure dynamics and Eustachian tube (ET) function during the Frenzel maneuver. The aim of the present study was to characterize the ET function during the Frenzel maneuver. Materials and methods By means of an established standardized profile of compression and decompression in a hypo/hyperbaric pressure chamber, we examined different parameters such as the ET opening pressure (ETOP), ET opening duration (ETOD), and ET opening frequency (ETOF) in 11 experienced apnea divers and compared them to the parameters during the Valsalva and Toynbee maneuver. Results Standard values for ETOP, ETOD, and ETOF could be established for the Frenzel maneuver under standardized conditions in a hypo/hyperbaric pressure chamber. Compared to the Frenzel maneuver, ETOP was higher and ETOD longer (both p < 0.001) during the Valsalva maneuver whereas ETOP was lower and ETOD shorter (both p < 0.001) during the Toynbee maneuver. No difference regarding ETOF was observed between the Frenzel, Valsalva, and Toynbee maneuver. Discussion The Frenzel maneuver was shown to be at least as effective as the Valsalva maneuver concerning ET opening. We believe that knowledge of the Frenzel technique might facilitate the pressure equalization during diving and recommend implementation of an appropriate equalization training in apnea and scuba diving education.

Reliability of Eustachian tube function measurements in a hypobaric and hyperbaric pressure chamber

2017 ◽  
Vol 42 (6) ◽  
pp. 1343-1349 ◽  
Author(s):  
M.F. Meyer ◽  
S. Jansen ◽  
O. Mordkovich ◽  
K.-B. Hüttenbrink ◽  
D. Beutner
Keyword(s):  
Eustachian Tube ◽  
Pressure Chamber ◽  
Eustachian Tube Function ◽  
Hyperbaric Pressure ◽  
Tube Function

Measuring dynamic Eustachian tube function using tympanometry in a pressure chamber: the effect of nasal betahistine application

2019 ◽  
Vol 133 (7) ◽  
pp. 580-587 ◽  
Author(s):  
B K-H G Franz ◽  
R Patuzzi ◽  
C J Wraight ◽  
G Kay ◽  
A Ng ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Animal Studies ◽  
Pressure Chamber ◽  
Chamber Pressure ◽  
Eustachian Tube Function ◽  
Hyperbaric Chamber ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function

AbstractObjectiveTo assess the effect of topical betahistine on Eustachian tube function in subjectively abnormal subjects in a hyperbaric chamber.MethodActive and passive Eustachian tube function was examined using tympanometry in a pressure chamber.ResultsActive Eustachian tube function was tested against the negative middle ear pressure induced by increasing the chamber pressure to +3 kPa. One voluntary swallow decreased middle-ear pressure by a mean of 1.36 kPa. Passive Eustachian tube function was tested by measuring spontaneous Eustachian tube openings as the chamber pressure dropped from +10 kPa to ambient. Four distinct patterns of Eustachian tube behaviour were seen, three of which indicated Eustachian tube dysfunction. Betahistine had no positive effect on Eustachian tube opening, although previous animal studies had suggested a beneficial effect.ConclusionTopical betahistine had no effect on Eustachian tube function. Combining a hyperbaric chamber with tympanometry proved ideal for evaluating Eustachian tube function.

Evacuation of the Middle Ear by Sniffing: A Cause of High Negative Pressure and Development of Middle Ear Disease

1984 ◽  
Vol 92 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Bernt Falk ◽  
Bengt Magnuson
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Negative Pressure ◽  
Experimental Studies ◽  
Eustachian Tube Function ◽  
Middle Ear Effusion ◽  
Pressure Equalization ◽  
Tube Function ◽  
Middle Ear Disease ◽  
Ear Effusion

Previous research on eustachian tube function has been devoted mainly to the study of the tubal opening ability and pressure equalization. This article summarizes a series of experimental studies focusing on the closing ability of the tube. Results support the belief that the purpose of the tube should be seen primarily as protecting the middle ear from the extensive pressure variations that physiologically take place in the nasopharynx. A number of studies of diseased ears have shown that tubal malfunction was characterized mainly by a reduced ability to withstand negative pressure in the nasopharynx. Sniffing can evacuate the middle ear, causing high negative intratympanic pressure. It seems likely that this mechanism is involved in the development of middle ear effusion and manifest retraction-type middle ear disease.

Comparative Preoperative Evaluation of Eustachian Tube Function in Pathological Ears

1980 ◽  
Vol 89 (4) ◽  
pp. 366-369 ◽  
Author(s):  
H. Virtanen ◽  
T. Palva ◽  
T. Jauhiainen
Keyword(s):  
Eustachian Tube ◽  
Negative Pressure ◽  
Preoperative Evaluation ◽  
Tympanic Membrane Perforation ◽  
Eustachian Tube Function ◽  
Pressure Equalization ◽  
Middle Ear Pressure ◽  
Membrane Perforation ◽  
Tube Function ◽  
Mucosal Changes

On 100 pathological ears with tympanic membrane perforation, eustachian tube function was measured by using sonotubometry and the negative pressure equalization test in an attempt to compare these two methods. The pressure equalization test did not appear to be a reliable tool for preoperative clinical determination of tube function because sonotubometry showed tubal opening in 85 % (myringoplasty group) and in 49 % (radical surgery group) of pathological ears, which were not able to equalize negative middle ear pressure at all during swallowing. The negative pressure equalization test is considered to be unphysiological and may produce a locking phenomenon of the tube. Even a small negative pressure can act like a valve, producing an obstruction that muscle activity of the tube is no longer able to overcome particularly when mucosal changes are present in the tubal orifice. Sonotubometry is a physiological test and as such gives a reliable picture of the opening of the tube during swallowing. Data on tympanic aeration postoperatively will be reported later.

Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study

2021 ◽  
Vol 59 (6) ◽  
pp. 560-566
Author(s):  
X. Chen ◽  
H. Dang ◽  
Q. Chen ◽  
Z. Chen ◽  
Y. Ma ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Prospective Study ◽  
Eustachian Tube ◽  
Endoscopic Sinus Surgery ◽  
Valsalva Maneuver ◽  
Sinus Surgery ◽  
Eustachian Tube Function ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Snot 22

Background: Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement. Methods: A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks. Results: A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score. Conclusions: This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

Eustachian Tube Function and Retraction of the Tympanic Membrane

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 65-66 ◽  
Author(s):  
Jörgen Holmquist ◽  
Ulf Renvall ◽  
Pål Svendsen
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Air Pressure ◽  
Eustachian Tube Function ◽  
Present Material ◽  
Pressure Equalization ◽  
Air Volume ◽  
Middle Ear Cholesteatoma ◽  
Tube Function

The medial displacement of the tympanic membrane or the retracted tympanic membrane is a common clinical finding. Also, retractions are looked upon as the precursor of middle ear cholesteatoma. In current otologic literature there seems to be some dispute whether the retractions of the tympanic membrane are caused by negative intratympanic air pressure or by shrinkage of middle ear adhesions pulling the tympanic membrane or part of it medially. In this study only ears with posterior/superior retractions of the tympanic membrane were investigated. Tympanometry revealed that only 33% of the ears did have middle ear pressure within ± 100 mm H2O. After insertion of a polyethylene tube through the tympanic membrane, the eustachian tube function was tested using the air pressure equalization technique. None of the ears could change the negative air pressure upon swallowing. Planometric measurements on the x-ray of the mastoid air cell system of the present material deviate from those of a normal material, indicating a significantly smaller air volume in the present material. It may be concluded that dysfunction of the eustachian tube and a small air volume of the mastoid are characteristic features of an ear with posterior/superior retraction of the tympanic membrane.

The Effect of Surfactant on Eustachian Tube Function in a Gerbil Model of Otitis Media with Effusion

1994 ◽  
Vol 110 (1) ◽  
pp. 110-114
Author(s):  
Ilsa Schwartz ◽  
John A. Fornadley ◽  
J. Kevin Burns
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Exogenous Surfactant ◽  
Eustachian Tube Function ◽  
Opening Pressure ◽  
Dramatic Decrease ◽  
Tube Function ◽  
Relationship Of ◽  
The Relationship

The relationship of eustachian tube surfactant and otitis media with effusion on eustachian tube opening pressure was studied in a gerbil model. Injection of killed Streptococcus pneumoniae bacteria created a serous effusion that increased eustachian tube opening pressure. The introduction of exogenous surfactant to this system resulted in a dramatic decrease in eustachian tube opening pressure in both normal ears and those with effusion. Identifying means to increase surfactant in the eustachian tube could be beneficial in reducing persistent otitis media with effusion.

scholarly journals Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers

2017 ◽  
Vol 47 (4) ◽  
pp. 223-227
Author(s):  
Stefanie Jansen ◽  
◽  
Manuela Boor ◽  
Moritz F Meyer ◽  
Eberhard D Pracht ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Peak Pressure ◽  
Eustachian Tube Function ◽  
Pressure Equalization ◽  
Negative Shift ◽  
Scuba Divers ◽  
Tube Function ◽  
Eustachian Tube Function Test ◽  
Recreational Scuba

Introduction: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). Methods: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. Results: Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). Conclusion: Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.

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