Relation between temporal bone pneumatisation and middle-ear barotrauma in aircrew members

AbstractObjectiveThis study aimed to assess the potential role of pneumatisation of the mastoid and its communicating air cells in the development of middle-ear barotrauma in aircrew members.MethodsSeventy-nine aircrew members (158 ears) underwent temporal computed tomography. All were assessed before flying by clinical examination and audiology evaluation, followed by post-flight examination to detect barotrauma.ResultsAircrew members’ ears were divided into 3 groups based on barotrauma and temporal bone pneumatisation: 33 ears with barotrauma and temporal bone pneumatisation of 71 cm3 or greater (group A); 12 ears with barotrauma and temporal bone pneumatisation of 11.2 cm3 or lower (group B); and 113 ears with no barotrauma (group C). Mean pneumatisation volumes were 91.05 cm3, 5.45 cm3 and 28.01 cm3 in groups A, B and C, respectively. A direct relationship was observed between volume of temporal bone pneumatisation of 71 cm3 or greater and barotrauma grade.ConclusionPneumatisation volume of the mastoid and its communicating air cells that ranges from 11.3 cm3 to 70.4 cm3 serves as a reliable predictor of the avoidance of middle-ear barotrauma associated with flying in aircrew members who have normal resting middle-ear pressure and good Eustachian tube function.

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Use of the nine-step inflation/deflation test and resting middle-ear pressure range as predictors of middle-ear barotrauma in aircrew members

The Journal of Laryngology & Otology ◽

10.1017/s0022215114001467 ◽

2014 ◽

Vol 128 (7) ◽

pp. 612-617 ◽

Cited By ~ 7

Author(s):

A Hussein ◽

A Abousetta

Keyword(s):

Negative Predictive Value ◽

Middle Ear ◽

Predictive Value ◽

Pressure Range ◽

Test Results ◽

Randomised Study ◽

Middle Ear Pressure ◽

Group A ◽

Group B

AbstractObjective:To explore the role of the nine-step inflation/deflation tympanometric test and resting middle-ear pressure range as predictors of barotrauma in aircrew members.Methods:A prospective, non-randomised study was conducted on 100 aircrew members. Resting middle-ear pressure was measured and the nine-step inflation/deflation test performed on all subjects before flights. Subjects were allocated to two groups according to resting middle-ear pressure range (group A, within the range of +26 to +100 and −26 to −100 mmH2O; group B, −25 to +25 mmH2O). All aircrew members were assessed after flights regarding the presence and the grade of barotrauma.Results:In both groups, the sensitivity and specificity values of the entire post-inflation/deflation test were close to those of the post-deflation part of the test. The post-deflation test had a higher negative predictive value than the post-inflation test. Ears with resting middle-ear pressure lower than −55 mmH2O experienced barotrauma, regardless of good or poor post-inflation or post-deflation test results.Conclusion:In an aircrew member, a resting middle-ear pressure within the range of −55 and +50 mmH2O, together with good post-deflation test results, are considered reliable predictors for fitness to fly.

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Does Septoplasty Affect Middle Ear Pressure and Eustachian Tube Function?

Erciyes Medical Journal ◽

10.5152/etd.2014.8745 ◽

2014 ◽

Vol 36 (3) ◽

pp. 115-118 ◽

Cited By ~ 1

Author(s):

Mehmet Ilhan Sahin ◽

Safak Gulec ◽

Umit Perisan ◽

Ismail Kulahli

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Eustachian Tube Function ◽

Middle Ear Pressure ◽

Tube Function

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215119001270 ◽

2019 ◽

Vol 133 (7) ◽

pp. 580-587 ◽

Cited By ~ 1

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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The Response of the Nasal Airway, Middle Ear, and Eustachian Tube to Experimental Rhinovirus Infection

American Journal of Rhinology ◽

10.2500/105065888781692961 ◽

1988 ◽

Vol 2 (4) ◽

pp. 149-154 ◽

Cited By ~ 29

Author(s):

William J. Doyle ◽

Timothy P. McBride ◽

J. Douglas Swarts ◽

Frederick G. Hayden ◽

Jack M. Gwaltney

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Clearance Rate ◽

Mucociliary Clearance ◽

Nasal Congestion ◽

Eustachian Tube Function ◽

Nasal Patency ◽

Rhinovirus Infection ◽

Middle Ear Pressure ◽

Tube Function

This paper describes the longitudinal changes in nasal patency, mucociliary clearance rate, eustachian tube function, and middle ear pressure in a group of 40 volunteers infected with rhinovirus type 39. Thirty-two (80%) of the volunteers were judged to have had a cold based on the modified Jackson criteria. Common symptoms included malaise, nasal congestion, rhinorrhea, and sneezing that began on the day after challenge and peaked in intensity on days 3–5. Nasal patency evaluated by active posterior rhinomanometry and mucociliary clearance rate evaluated by the dyed sacharrin technique were significantly decreased following challenge. For nasal patency the effect was primarily limited to days 2–8 postchallenge, while abnormalities in clearance rate were documented for as long as 18 days postchallenge. A 50% increased incidence of abnormal eustachian tube function and a 30% increased incidence of abnormal middle ear pressures were observed for days 2–7 postchallenge with a gradual return to baseline by day 16. For mucociliary clearance, eustachian tube function, and middle ear pressure, but not nasal patency, these abnormalities were more pronounced in patients with a symptomatic cold. These results show that changes in nasal physiology resulting from a rhinovirus infection can be objectively quantified and that the resulting pathophysiology extends to anatomically contiguous structures such as the eustachian tube and middle ear.

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Effects of freediving on middle ear and eustachian tube function

Diving and Hyperbaric Medicine Journal ◽

10.28920/dhm50.4.350-355 ◽

2020 ◽

Vol 50 (4) ◽

pp. 350-355

Author(s):

Moritz F Meyer ◽

◽

Kristijana Knezic ◽

Stefanie Jansen ◽

Heinz D Klünter ◽

...

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Cumulative Effect ◽

Eustachian Tube Function ◽

Diving Depth ◽

Middle Ear Pressure ◽

Tube Function ◽

Hyperbaric Medicine ◽

The Right ◽

Peak Pressures

(Meyer MF, Knezic K, Jansen S, Klünter HD, Pracht ED, Grosheva M. Effects of freediving on middle ear and eustachian tube function. Diving and Hyperbaric Medicine. 2020 December 20;50(4):350–355. doi: 10.28920/dhm50.4.350-355. PMID: 33325015.) Introduction: During descent in freediving there is exposure to rapidly increasing pressure. Inability to quickly equalise middle ear pressure may cause trauma to the ear. This study aimed to evaluate the occurrence of pressure-related damage to the middle ear and the Eustachian tube during freediving and to identify possible risk factors. Methods: Sixteen free divers performed diving sessions in an indoor pool 20 metres’ freshwater (mfw) deep. During each session, each diver performed four own free dives and up to four safety dives. Naso- and oto-endoscopy and Eustachian tube function tests were performed on the right and left ears before diving, between each session and after the last session. The otoscopic findings were classified according to the Teed classification (0 = normal tympanic membrane to 4 = perforation). Additionally, ENT-related complaints were assessed using a questionnaire. Results: Participants performed 317 dives (on average 20 dives per diver, six per session). The average depth was 13.3 mfw. Pressure-related changes (Teed 1 and 2) were detected in 48 % of ears. Teed level increased significantly with an increasing number of completed sessions (P < 0.0001). Higher pressure-related damage (Teed 2) occurred in less experienced divers, was associated with significantly lower peak pressures in the middle ear and led to more ear-related symptoms. A preference for the Frenzel technique for middle ear pressure equalisation during freediving was shown. Conclusions: Pressure exposure during freediving had a cumulative effect on the middle ear. Factors such as diving depth, diving experience and number of diving sessions correlated with the occurrence of higher Teed levels.

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VALSALVA MANOUEVRE;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.01.588 ◽

2012 ◽

Vol 20 (01) ◽

pp. 121-125

Author(s):

MUHAMMAD KHALID AZAM KHAN ◽

SHAHID BIN FAIZ ◽

ATIF RAFIQUE

Keyword(s):

Study Design ◽

Middle Ear ◽

Valsalva Maneuver ◽

Treatment Groups ◽

Nasal Decongestants ◽

Middle Ear Pressure ◽

Group A ◽

Group B

Objective: To assess the efficacy of Valsalva maneuver in the treatment of Eustachian catarrh. Study design: QuasiExperimental Study. Place and duration of study: Frontier corp Hospital (Quetta) and Sheikh Khalifa Bin Zayad Al Nahyan Hospital(Muzzafarabad) from December 2010 to May 2011. Patients and methods: Total of sixty patients of Eustachian catarrh were randomlyassigned to two treatment groups. Group A was given Antibiotics, Antihistamine, systemic and nasal decongestants and group B wasadvised Valsalva maneuver in addition to the above mention treatment. Relief in aural fullness (assessed through tympanometry) andhearing improvement (assessed through audiometry) were compared between these two groups at the end of three weeks of treatment.Results: Audiogram done after three weeks of treatment showed statistically significant hearing and middle ear pressure improvement(assessed through audiogram and tympanogram respectively) in group B.

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Retorospective Evaluation of the Role of Anterior Tympanotomy in Reccurent Middle Ear Cholesteatoma Cases Based upon Eustachian Tube Function

Practica oto-rhino-laryngologica Suppl ◽

10.5631/jibirinsuppl1986.2000.supplement104_7 ◽

2000 ◽

Vol 2000 (Supplement104) ◽

pp. 7-12

Author(s):

Tsuyoshi Matsumoto ◽

Taeko Kusumi ◽

Men-dar Wu ◽

Meiho Nakayama ◽

Shigeru Inafuku ◽

...

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Eustachian Tube Function ◽

Middle Ear Cholesteatoma ◽

Tube Function

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Abnormal middle ear pressures during experimental influenza A virus infection — role of Eustachian tube function

Auris Nasus Larynx ◽

10.1016/s0385-8146(00)00075-4 ◽

2000 ◽

Vol 27 (4) ◽

pp. 323-326 ◽

Cited By ~ 15

Author(s):

William J Doyle ◽

James T Seroky ◽

Betty L Angelini ◽

Mehmet Gulhan ◽

David P Skoner ◽

...

Keyword(s):

Virus Infection ◽

Influenza A Virus ◽

Eustachian Tube ◽

Middle Ear ◽

Influenza A ◽

Eustachian Tube Function ◽

Tube Function ◽

Influenza A Virus Infection ◽

Experimental Influenza

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Nebulized surfactant as a treatment choice for otitis media with effusion: an experimental study in the rabbit

The Journal of Laryngology & Otology ◽

10.1258/0022215011907848 ◽

2001 ◽

Vol 115 (5) ◽

pp. 363-368 ◽

Cited By ~ 11

Author(s):

Muhsin Koten ◽

Cem Uzun ◽

Recep Yaǧiz ◽

Mustafa Kemal Adali ◽

Ahmet Rifat Karasalihoglu ◽

...

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Physiological Saline ◽

Control Group ◽

Eustachian Tube Function ◽

Middle Ear Pressure ◽

Tube Function ◽

Experimentally Induced

Exogenous surfactant can improve eustachian tube function in experimentally induced otitis media with effusion (OME). Performing tympanometric recordings, the efficacy of inhaled nebulized surfactant, as compared with inhaled nebulized physiological saline was investigated, for the treatment of OME experimentally induced in the rabbit by intrabullar inoculation of heat-killed Streptococcus pneumoniae. In addition, the histological changes in middle ears after the treatment were investigated in order to establish whether the pathological findings correlated with the results.Middle-ear pressure values before, and after, treatment were analyzed by the Wilcoxon statistical method, and the Mann-Whitney U test was used to compare the post-treatment values between groups. In all ears with OME in the affected animals, which were treated with nebulized surfactant inhalation, a positively significant (p<0.05) increase of pressure more than 20 daPa was recorded. In the control group, after inhalation of nebulized physiological saline, there was no positive increase in the affected middle-ear pressures; on the contrary, more negative pressure changes were recorded. In the histological evaluation, middle-ear epithelia and sub-epithelial space were normal in surfactant-treated ears with OME, whereas mucosal thickening with an oedematous sub-epithelial space containing occasional inflammatory cells and increases in connective tissue and vascularity, and effusions on the epithelial surface were present in the ears with OME in the control group. The significant improvement in the negative middle-ear pressure after nebulized surfactant treatment and the histological findings shown in our study can support the theory that surface-active agents are of importance in eustachian tube function even under pathologic conditions, such as OME.

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