Value of middle ear inflation as a diagnostic indicator of eustachian tube patency

1990 ◽  
Vol 104 (2) ◽  
pp. 134-137 ◽  
Author(s):  
M. Luntz ◽  
J. Sadé
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Diagnostic Procedure ◽  
Diagnostic Value ◽  
Tympanic Cavity ◽  
Tubal Patency ◽  
Tube Obstruction ◽  
Tube Dysfunction ◽  
And Function ◽  
Diagnostic Indicator

AbstractThe value of tubal inflation as a diagnostic procedure for Eustachian tube patency and function is controversial. In an attempt to assess the diagnostic value of air douche in atelectatic ears, 49 such ears of 40 patients were politzerized. The procedure was successful in 45 ears. However, of the four unsuccessful cases, two of the patients were able to autoinflate their ears. These results show that air douches pass regularly through the Eustachian tube into the tympanic cavity even in atelectatic ears, which by definition suffer from aeration deficiency, which is often considered to be secondary to ‘Eustachian tube obstruction’, or alternatively ‘Eustachian tube dysfunction’. Thus, the ability to force air through the Eustachian tube by politzerization is of no diagnostic value as an indicator of normal or abnormal tubal patency or functioning in atelectatic ears and most probably in allied conditions.

Causes of failure of combined approach tympanoplasty in the treatment of acquired cholesteatomas of the middle ear and the mastoid

1995 ◽  
Vol 109 (8) ◽  
pp. 710-712 ◽  
Author(s):  
T. R. Kapur
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Squamous Epithelium ◽  
Combined Approach ◽  
Tube Obstruction ◽  
Incomplete Removal ◽  
Tube Dysfunction ◽  
Cause Of Failure ◽  
Causes Of Failure

AbstractForty cases of failed combined approach tympanoplasty were analysed. The commonest cause of failure was adhesions between the facial ridge and the tympanic membrane, causing segmental attico-mastoid malaeration in 51.3 per cent of cases followed-up continually. Other causes were, large dermoids, incomplete removal of squamous epithelium, and eustachian tube obstruction. Eustachian tube dysfunction did not appear to be a major cause of failure.

Proof of concept study using a modified Politzer inflation device as a rescue modality for treating Eustachian tube dysfunction during hyperbaric oxygen treatment in a multiplace (Class A) chamber

2019 ◽  
pp. 55-61
Author(s):  
Owen J. O’Neill ◽  
Elizabeth Smykowski ◽  
Jo Ann Marker ◽  
Lubiha Perez ◽  
drah Gurash ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Tube Placement ◽  
Treatment Schedule ◽  
Surgical Interventions ◽  
Hyperbaric Treatment ◽  
Middle Ear Pressure ◽  
Tube Dysfunction

Introduction: Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are the most common adverse effects of hyperbaric oxygen (HBO2) treatments. Patients practice equalization maneuvers to prevent ETD and MEB prior to hyperbaric exposure. Some patients are still unable to equalize middle ear pressure. This ETD results in undesirable consequences, including barotrauma, treatment with medications or surgical myringotomy with tube placement and interruption of HBO2. When additional medications and myringotomy are employed, they are associated with additional complications. Methods: A device known as the Ear Popper® has been reported to reduce complications from serous otitis media and reduce the need for surgical interventions (myringotomy). Patients unable to equalize middle ear pressure during initial compression in the hyperbaric chamber were allowed to use the device for rescue. All hyperbaric treatments were compressed using a United States Navy TT9, or a 45-fsw hyperbaric treatment schedule. Patients with persistent ETD and the inability to equalize middle ear pressure were given the Ear Popper upon consideration of terminating their treatment. Results: The Ear Popper allowed all patients to successfully equalize middle ear pressure and complete their treatments. Conclusion: This study substantiates the use of this device to assist in allowing pressurization of the middle ear space in patients otherwise unable to achieve equalization of middle ear pressure during HBO2 treatment in a multiplace chamber.

Middle Ear Pressure and Dysfunction of the Labyrinth: Is There a Relationship?

1997 ◽  
Vol 106 (6) ◽  
pp. 478-482 ◽  
Author(s):  
Wolfgang Maier ◽  
Milo Fradis ◽  
Uwe Ross ◽  
Bernhard Richter
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Sudden Hearing Loss ◽  
Cochlear Function ◽  
Pressure Equalization ◽  
Middle Ear Pressure ◽  
Patient Reported ◽  
Tube Dysfunction ◽  
Ventilation Tubes ◽  
Vestibular Neuronitis

Relationships between middle ear pressure and non-infection-related cochleovestibular dysfunction have been suggested by several authors. According to some data, vertiginous attacks can be prevented by the insertion of a ventilation tube in patients suffering from Meniere's syndrome. The aim of our study was to investigate if the incidence of eustachian tube malfunction and pathologic middle ear pressure is frequent, and if routine implantation of ventilation tubes is reasonable in ears with dysfunctions of the labyrinth, including clinical Meniere's syndrome. So, we determined in our pressure chamber all active and passive parameters of eustachian tube function in 40 patients suffering from Meniere's syndrome, sudden sensory hearing impairment (SSHI), or vestibular neuronitis. Our results disclosed no nonrandom incidence of impaired tubal function among our patients compared to healthy control subjects. Pressure equalization was sufficient in most patients suffering from clinical Meniere's syndrome, and only one patient with vestibular neuronitis presented with a patulous tube. Our results show that impairment of vestibular or cochlear function is not regularly accompanied by eustachian tube dysfunction. Furthermore, no patient reported symptoms while pressure variation was performed. We conclude that variation of middle ear pressure does not usually play a role in the genesis of Meniere's syndrome, vestibular neuronitis, or SSHI. Thus, from our data, we cannot recommend routine implantation of tympanic ventilation tubes in patients suffering from Meniere's syndrome, vestibular neuronitis, or sudden hearing loss.

The Role of Eustachian Tube Dysfunction in Immune-Mediated Middle Ear Effusion and Inflammation

1985 ◽  
Vol 12 ◽  
pp. S203-S205 ◽  
Author(s):  
Allen F. Ryan ◽  
Jeffrey P. Harris ◽  
Antonino Catanzaro ◽  
Stephen I. Wasserman
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Middle Ear Effusion ◽  
Immune Mediated ◽  
Tube Dysfunction ◽  
Ear Effusion

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.

Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation

2017 ◽  
Vol 131 (9) ◽  
pp. 817-822 ◽  
Author(s):  
O Ilan ◽  
E-L Marcus ◽  
Y Cohen ◽  
T Farkash ◽  
R Levy ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Tracheostomy Tube ◽  
Oral Feeding ◽  
Eustachian Tube Dysfunction ◽  
Impaired Consciousness ◽  
Endoscopic Gastrostomy ◽  
Tube Dysfunction ◽  
Cognitively Intact

AbstractObjective:This study aimed to investigate the prevalence of and risk factors for Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation via tracheostomy tube.Methods:A total of 40 patients on chronic ventilation were included in a prospective cohort study. Middle-ear status was determined by tympanometry. Tympanograms were categorised as types A, B or C; types B and C were defined as middle-ear pathology.Results:In all, 57 ears of 40 patients were examined. Disease was found in at least 1 ear in 26 out of 40 patients. Middle-ear pathology was found in 25 out of 34 patients who were tube fed (via nasogastric tube or percutaneous endoscopic gastrostomy) vs 1 patient out of the 6 fed orally (p = 0.014), and in 23 out of 31 with conscious or cognitive impairment vs 3 out of 9 cognitively intact patients (p = 0.044).Conclusion:Middle-ear pathology is common in patients on chronic mechanical ventilation via tracheostomy tube. The highest prevalence was in those with impaired consciousness or cognition, and oral feeding appeared protective.

Intraluminal three-dimensional optical coherence tomography – a tool for imaging of the Eustachian tube?

2019 ◽  
Vol 133 (2) ◽  
pp. 87-94 ◽  
Author(s):  
R Schuon ◽  
B Mrevlje ◽  
B Vollmar ◽  
T Lenarz ◽  
G Paasche
Keyword(s):  
Optical Coherence Tomography ◽  
Eustachian Tube ◽  
Cross Sections ◽  
Ex Vivo ◽  
Three Dimensional ◽  
Diagnostic Value ◽  
Optical Coherence ◽  
Experimental Conditions ◽  
Non Invasive ◽  
Tube Dysfunction

AbstractObjectivesThe cause of Eustachian tube dysfunction often remains unclear. Therefore, this study aimed to examine the feasibility and possible diagnostic use of optical coherence tomography in the Eustachian tube ex vivo.MethodsTwo female blackface sheep cadaver heads were examined bilaterally. Three conditions of the Eustachian tube were investigated: closed (resting position), actively opened and stented. The findings were compared (and correlated) with segmented histological cross-sections.ResultsIntraluminal placement of the Eustachian tube with the optical coherence tomography catheter was performed without difficulty. Regarding the limited infiltration depth of optical coherence tomography, tissues can be differentiated. The localisation of the stent was accurate as was the lumen.ConclusionThe application of optical coherence tomography in the Eustachian tube under these experimental conditions is considered to be a feasible, rapid and non-invasive diagnostic method, with possible diagnostic value for determining the luminal shape and superficial lining tissue of the Eustachian tube.

scholarly journals Eustachian Tube Dysfunction and Wideband Absorbance Measurements at Tympanometric Peak Pressure and 0 daPa

2019 ◽  
Vol 30 (09) ◽  
pp. 781-791 ◽  
Author(s):  
Sreedevi Aithal ◽  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Shane Anderson ◽  
Simon Liebenberg
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Repeated Measures ◽  
Peak Pressure ◽  
Cross Sectional Study ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tube Dysfunction

AbstractAlthough wideband absorbance (WBA) provides important information about middle ear function, there is limited research on the use of WBA to evaluate eustachian tube dysfunction (ETD). To date, WBA obtained under pressurized condition has not been used to evaluate ETD.The objective of the study was to compare WBA at 0 daPa and tympanometric peak pressure (TPP) conditions in healthy ears and ears with ETD.A cross-sectional study design was used.A total of 102 healthy ears from 79 participants (mean age = 10.0 yr) and 43 ears from 32 patients with ETD (mean age = 16.0 yr) were included in this cross-sectional study. WBA was measured at 0 daPa (WBA0) and TPP WBA at TPP (WBATPP).WBA results were analyzed using descriptive statistics and t-tests with the Bonferroni correction. An analysis of variance with repeated measures was applied to the data.WBA0 was significantly lower in the ETD group than in the control group. The WBA0 of the control group demonstrated a broad peak between 1.25 and 4 kHz, whereas the WBA0 of the ETD group had a peak between 2.5 and 4 kHz. WBATPP of the ETD group approached values close to that of the control group. In the control group, WBATPP was only 0.06 to 0.09 higher than WBA0, whereas in the ETD group, WBATPP was 0.29 to 0.42 higher than WBA0 between 0.6 and 1.5 kHz. A differential pattern of WBA at TPP relative to 0 daPa was observed between ears with ETD and ears with otitis media with effusion (OME) and negative middle ear pressure (NMEP).Hence, a comparison of WBA0 and WBATPP can provide potentially useful diagnostic information, and hence can be used as an adjunct tool to evaluate ETD. This is important especially in young children or some adults who are unable to perform maneuvers such as Toynbee or Valsalva during ETD assessment. Further research is needed to verify the results using test performance measures to determine whether WBA0 and WBATPP can objectively determine the presence of ETD or OME with NMEP.

Pseudomonas Otitis Media after Eustachian Tube Obstruction

1992 ◽  
Vol 107 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Patrick J. Antonelli ◽  
Steven K. Juhn ◽  
Marcos V. Goycoolea ◽  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Tube Obstruction ◽  
Colony Forming Units ◽  
Tube Function ◽  
Pseudomonas Infection

Previous experiments have shown that Pseudomonas aeruginosa may infect the middle ears of chinchillas by way of the eustachian tube and that chinchillas with acute otitis media (AOM) are more susceptible to pseudomonas infection than animals without AOM. The purpose of this experiment was to examine the effects of otitis media with effusion (OME), induced by means of eustachian tube obstruction, on middle ear susceptibility to nasal inoculation of P. aeruginosa. Chinchilla eustachian tubes were obstructed with silicone rubber sponge bilaterally; OME developed in eight animals (11 ears)—three bilaterally and five unilaterally—and persisted for 6 months. Ten chinchillas with normal eustachian tube function served as controls. All animals were nasally inoculated with 5 times 104 colony-forming units of P. aeruginosa. Pseudomonas otitis media developed in eight of 11 OME ears with effusion, none of five ears without OME, and four of 20 control ears (X2 = 11.782, p = 0.003). Therefore, P. aeruginosa can infect the middle ear by way of the eustachian tube. Tubal dysfunction may lead to the development of chronic suppurative otitis media by increasing tubotympanic susceptibility to opportunistic pathogens.

Experimental Retraction Pocket Cholesteatoma

1986 ◽  
Vol 95 (6) ◽  
pp. 639-644 ◽  
Author(s):  
David E. Wolfman ◽  
Richard A. Chole
Keyword(s):  
Animal Model ◽  
Experimental Evidence ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Mongolian Gerbils ◽  
Retraction Pocket ◽  
Tube Obstruction ◽  
Middle Ear Fluid ◽  
Acquired Cholesteatoma

An animal model for retraction pocket (primary acquired) cholesteatoma is presented. Bilateral eustachian tube obstruction by electrocauterization of the nasopharyngeal portion was performed in 16 Mongolian gerbils. Animals were killed at 2, 4, 8, and 16 weeks. At 2 weeks all animals had bilateral serous effusions and retracted tympanic membranes. At 4 weeks, four of eight ears had middle ear fluid, retractions, and cholesteatomas. After 8 weeks, five of eight ears had middle ear effusions, and four of these had cholesteatomas; one ear had total atelectasis with a cholesteatoma filling the bulla. By 16 weeks, six of eight ears had developed cholesteatomas. Some animals did not develop effusion or retraction because of failure or recanalization of eustachian tube obstruction. This study provides experimental evidence that aural cholesteatomas may arise by retraction of the tympanic membrane.

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