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.

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.

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.

Effect of nasogastric tubes on Eustachian tube function

1990 ◽  
Vol 104 (1) ◽  
pp. 17-19 ◽  
Author(s):  
M. Wake ◽  
D. E. McCullough ◽  
J. D. Binnington
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Nasogastric Tube ◽  
Cell System ◽  
Eustachian Tube Function ◽  
Nasogastric Tubes ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function

AbstractThe Eustachian tube acts as pressure equalizing tube between the nasopharynx and the middle ear. It also functions as a conduit for removal of secretions from the middle ear and mastoid air cell system into the post nasal space. Eustachian tube function may be assessed objectively using tympanometric measurements. (Brooks, 1968, Lutman, 1987).The post-operative use of nasogastric Ryles tubes is associated with reduced peak middle ear pressure (mmH2O) and reduced peak compliance volumes (ml) as assessed by tympanometry. In addition changes in the appearance of the tympanic membrane may occur with the protracted use of Ryles tubes. This phenomenon is a transient one.Nasogastric tube-induced Eustachian tube dysfunction is a previously unreported entity.

scholarly journals Assessment of eustachian tube dysfunction in middle ear pathologies

2018 ◽  
Vol 5 (1) ◽  
pp. 127
Author(s):  
T. Dinesh Singh ◽  
C. P. Sudheer
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Eustachian Tube Function ◽  
Auditory Tube ◽  
Postoperative Assessment ◽  
Tube Dysfunction ◽  
Tube Function

<p class="abstract"><strong>Background:</strong> Auditory tube dysfunction is suspected as primary cause of chronic otitis media and leads to surgical related complications in otitis media with tympanic membrane perforation. The diagnosis of eustachian tube malfunction is essential to know the pathogenesis of chronic otitis media.</p><p class="abstract"><strong>Methods:</strong> A total 150 cases and 75 age, sex matched control subjects between age group 20-50 years were selected. Pre and post-surgical history was noted and detailed ear examination, tympanometry was done. Auditory tube function was evaluated through Valsalva test, nasopharyngoscopy, pneumatic otoscopy. Intact tympanic membrane was assessed by Williams test, perforated tympanic membrane by Toynbee’s test.  </p><p class="abstract"><strong>Results:</strong> Postoperative assessment of eustachian tube function by Toynbee’s test for 19 cases with failed tympanoplasty showed normal ET function in 5 cases, 8 cases had partial and 6 cases had gross ET dysfunction. Postoperative assessment ET function by William’s test showed 4 cases among 19 cases had partial ET dysfunction and 01 cases had gross ET dysfunction.</p><p class="abstract"><strong>Conclusions:</strong> Efficient surgical outcome of middle ear complications always depends on eustachian tube function. Most of the cases with residual CP showed partial or gross ET dysfunction. Patients with tubal dysfunction should be evaluated for underlying cause and treatable causes should addressed before proceeding for surgery as it increases the success rate of tympanoplasty.</p>

Middle Ear Ventilation with HydroxylVent Tube: Review of the Initial Series

1993 ◽  
Vol 108 (6) ◽  
pp. 701-705 ◽  
Author(s):  
Anthony F. Jahn
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Conventional Ventilation ◽  
Eustachian Tube Dysfunction ◽  
Initial Series ◽  
Prolonged Ventilation ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction ◽  
Ventilation Tubes

Thirty HydroxylVent tubes were implanted in twenty-seven patients. The chief Indications were unresolving eustachian tube dysfunction, with either collapse or perforation of the tympanic membrane. Every patient had undergone a lengthy course of treatment with conventional ventilation tubes. Twenty ears (66%) showed good results, with prolonged ventilation and restoration of middle ear function. Two tubes appeared to be open, with the development of a pinpoint perforation of the drum. Eight tubes occluded as a result of displacement of the tube, middle ear pathology, or debris. Indications and techniques of management are discussed, along with an analysis of complications.

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.

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