Uncomplicated Eustachian Tube Dysfunction: The Site of the Nasal Septal Deformity

1982 ◽  
Vol 68 (1) ◽  
pp. 23-29
Author(s):  
W. D. McNicoll
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Nasal Septum ◽  
Ambient Pressure ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Royal Navy ◽  
Tube Dysfunction ◽  
Function Testing ◽  
Submucous Resection

AbstractEighty-nine recruit volunteers to the Submarine. Diving and Fleet Air Arm branches of the Royal Navy who were suffering from an unsuspected Eustachian tube dysfunction underwent investigation, which included middle ear analysis. Eustachian function testing and PA x-radiography of the skull. Twenty-five aircrew candidates who had positive Valsalva and Toynbee manoeuvres on otoscopy, acted as a control group and underwent the same investigations as the investigative group. All the subjects in the investigative group had either a unilateral or bilateral Eustachian tube dysfunction. This dysfunction was confirmed by exposing the subjects to an increase in ambient pressure not exceeding three metres of water. None of the subjects with Eustachian tube dysfunction were able to equilibrate their middle ear pressures at this depth equivalent.All 89 subjects were found to have a nasal septal deformity situated at the posterior half of the nasal septum at the level of the vomero-ethmoid suture. All the volunteers underwent submucous resection of the nasal septum, care being taken to excise the vomeroethmoid suture and the adjacent vomer and perpendicular plate of ethmoid. Six weeks after operation 85 (95.5%) of subjects were able to equilibrate their middle ear pressures when they were exposed to an increase in ambient pressure of 10 metres of water.

Submucous Resection: The Treatment of Choice in the Nose-Ear Distress Syndrome

1979 ◽  
Vol 65 (3) ◽  
pp. 123-130
Author(s):  
W. D. McNicoll ◽  
S. G. Scanlan
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Distress Syndrome ◽  
Ambient Pressure ◽  
Barometric Pressure ◽  
Eustachian Tube Dysfunction ◽  
Royal Navy ◽  
Tube Dysfunction ◽  
The Relationship ◽  
Submucous Resection

AbstractThe combination of nasal septal deviation and Eustachian tube dysfunction, in the absence of any other pathology, constitutes the Nose-Ear Distress Syndrome. We have undertaken a clinical assessment of the relationship between uncomplicated deviation of the nasal septum and Eustachian tube dysfunction in naval personnel who are serving in environments of primarily increased barometric pressure.One hundred and twenty candidates to the submarine, diving and aircrew branches of the Royal Navy who presented with the nose-ear distress syndrome were initially surveyed. None were able to equilibrate their middle ear pressures at an increased ambient pressure of 3 metres of water. Submucous resection was performed on 116, of whom 110 (94.83%) were able to equilibrate their middle ear pressures at an increased ambient pressure of 9 metres of water post-operatively.Xenon 113 scintigraphy was performed on a further 25 recruits to delineate the post-nasal airflow. This investigation was performed pre- and post-operatively. Pre-operatively, scintigraphy showed the presence of turbulence in the post-nasal space, while post-operatively the turbulence was absent. All the candidates were unable to equilibrate their middle ear pressures pre-operatively, but after submucous resection 24 (96%) were able to equilibrate their middle ear pressures at an increased barometric pressure of 9 metres of water.

Submucous resection

1979 ◽  
Vol 93 (4) ◽  
pp. 357-367 ◽  
Author(s):  
W. D. McNicoll ◽  
S. G. Scanlan
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Distress Syndrome ◽  
Ambient Pressure ◽  
Barometric Pressure ◽  
Eustachian Tube Dysfunction ◽  
Royal Navy ◽  
Tube Dysfunction ◽  
The Relationship ◽  
Submucous Resection

AbstractThe combination of nasal septal deviation and Eustachian tube dysfunction, in the absence of any other pathology, constitutes the Nose–Ear Distress Syndrome.We have undertaken a clinical assessment of the relationship between uncomplicated deviation of the nasal septum and Eustachian tube dysfunction in Naval Personnel who are serving in environments of primarily increased barometric pressure.120 candidates to the Submarine, Diving and Aircrew branches of the Royal Navy who presented with the Nose–Ear distress syndrome were initially surveyed. None were able to equilibrate their middle ear pressures at an increased ambient pressure of 3 metres of water. Submucous resection was performed on 116, of whom 110 (94·83 per cent) were able to equilibrate their middle ear pressures at an increased ambient pressure of 9 metres of water post-operatively.Xenon 133 Scintigraphy was performed on a further 25 recruits to delineate the post-nasal airflow. This investigation was performed pre- and post-operatively. Pre-operatively, Scintigraphy showed the presence of turbulence in the post-nasal space, while post-operatively the turbulence was absent. All the candidates were unable to equilibrate their middle ear pressures pre-operatively, but after submucous resection 24 (96 per cent) were able to equilibrate their middle ear pressures at an increased barometric pressure of 9 metres of water.

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.

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.

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

scholarly journals Gastroesophageal Reflux Disease: A Cause for Eustachian Tube Dysfunction in Obstructive Sleep Apnea

2020 ◽  
pp. 014556132093121
Author(s):  
Suying Yan ◽  
Yongxiang Wei ◽  
Xiaojun Zhan ◽  
Linyin Yao ◽  
Xiping Li ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Eustachian Tube ◽  
Reflux Disease ◽  
Eustachian Tube Dysfunction ◽  
Control Group ◽  
Obstructive Sleep ◽  
Tube Dysfunction

Objectives: To explore the effect of gastroesophageal reflux disease (GERD) on Eustachian tube function in patients with obstructive sleep apnea (OSA). Methods: This was a cross-sectional study. The patients were divided into 4 groups according to OSA and GERD: OSA+GERD group; OSA-only group; GERD-only group; and normal control group. Results: There were no differences among the 4 groups regarding age, sex, smoking history, and alcohol history (all P > .05). The patients in the OSA and OSA+GERD groups had a significantly larger body mass index than those in the control and GERD-only groups (all P < .05). The proportions of patients with abnormal ETS-7 and ETD-Q results were higher in the GERD and OSA+GERD groups compared to the control group ( P < .008). There were no significant differences in ETS-7 and ETD-Q between the control and the OSA-only groups ( P > .008). The multivariable analysis showed that only GERD was independently associated with abnormal ETS-7 results (odds ratio = 3.090, 95% CI: 1.332-7.169, P = .009). Conclusion: Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA.

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.

Nasal and Otologic Effects of Experimental Influenza a Virus Infection

1994 ◽  
Vol 103 (1) ◽  
pp. 59-69 ◽  
Author(s):  
William J. Doyle ◽  
Craig A. Buchman ◽  
David P. Skoner ◽  
James T. Seroky ◽  
Frederick Hayden ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Influenza A ◽  
Serum Antibody ◽  
Eustachian Tube Dysfunction ◽  
Upper Respiratory Tract ◽  
Tube Dysfunction ◽  
Antibody Titers ◽  
Experimental Influenza

Past studies showed that experimental rhinovirus colds in adults resulted in eustachian tube dysfunction and abnormal middle ear pressures. In the present study, the symptoms and pathophysiologic findings accompanying experimental influenza viral infection were documented. A total of 33 healthy adult volunteers were intranasally challenged with an influenza A/Kawasaki/86 (H1N1) virus and cloistered over a 9-day postchallenge period to monitor for evidence of infection, signs and symptoms of illness, and the extent and frequency of pathophysiologic responses of the nose, eustachian tube, and middle ear. Results showed a protective effect of high (≥16) prechallenge specific hemagglutination-inhibition antibody titer on the rate of infection and the magnitude and extent of provoked symptoms and pathophysiologic findings. Infected subjects with low (<16) prechallenge serum antibody titers (n = 21) developed significant respiratory illness. These subjects also had objectively measurable increases in nasal secretion production, and decreased nasal patency and mucociliary clearance rates. More than 80% of the infected subjects developed eustachian tube dysfunction, and approximately 80% had middle ear underpressures of less than −100 mm H2O on study days 4 and 5. Five of 21 infected subjects with low prechallenge antibody titers had otoscopic evidence of otitis media with effusion. These results support a causal role for viral upper respiratory tract infection in the pathogenesis of otitis media, possibly mediated by the early development of eustachian tube dysfunction and abnormal middle ear pressure.

Immune Modulatory Oligonucleotides in the Prevention and Treatment of OVA-Induced Eustachian Tube Dysfunction in Rats

2007 ◽  
Vol 137 (2) ◽  
pp. 321-326 ◽  
Author(s):  
Deidra A. Blanks ◽  
Charles S. Ebert ◽  
Rose P. Eapen ◽  
Carlton Zdanski ◽  
Ekambar R. Kandimalla ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Negative Pressure ◽  
Mucociliary Clearance ◽  
Otitis Media With Effusion ◽  
Allergic Inflammation ◽  
Eustachian Tube Dysfunction ◽  
Brown Norway ◽  
Control Group ◽  
Prevention And Treatment ◽  
Tube Dysfunction

BACKGROUND: Otitis media with effusion (OME) is often associated with allergies. Immune modulatory oligonucleotides (IMO) mediate allergic inflammation and may therefore be efficacious in the treatment of airway inflammation. OBJECTIVE: To evaluate the role of an IMO via transtympanic mucosal application in prevention and treatment of ovalbumin-induced OME. DESIGN: Forty brown Norway rats were divided into control and treatment groups. Eustachian tube dysfunction was evaluated by passive opening pressures, passive closing pressures, active clearance of negative pressure, and mucociliary clearance transit time. RESULTS: Rats who underwent IMO treatment required 50% less pressure to open and close the eustachian tube ( P < 0.05) and were able to actively clear 50% more negative pressure than the ovalbumin-control rats ( P < 0.001). The treatment rats' mucociliary clearance time was half that of the control group ( P < 0.001). CONCLUSION: IMO via transtympanic application can prevent and treat allergy-induced eustachian tube dysfunction in rats. IMO may offer substantial promise in the future management of OME.

scholarly journals Chronic obstructive Eustachian tube dysfunction: CT assessment with Valsalva maneuver and ETS-7 score

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247708
Author(s):  
Diletta Angeletti ◽  
Annalisa Pace ◽  
Giannicola Iannella ◽  
Valeria Rossetti ◽  
Andrea Colizza ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Eustachian Tube Dysfunction ◽  
Diagnostic Tools ◽  
Chronic Obstructive ◽  
Temporal Bone Ct ◽  
Before And After ◽  
Tube Dysfunction ◽  
Strong Suspicion

Chronic obstructive Eustachian tube dysfunction (ETD) is a common disorder of the middle ear. In recent years, two main diagnostic tools have become available: Eustachian tube score (ETS-7) and computed tomography (CT) combined with Valsalva maneuver. The aim of this study is to evaluate the outcomes of ETS-7 and CT in a group of patients affected by middle ear atelectasis with a strong suspicion of ETD. Three males and nine females, affected by middle ear atelectasis with retraction of the TM were enrolled. Each patient underwent to Eustachian tube dysfunction evaluation adopting the ETS-7 score and a temporal bone CT with Valsalva maneuver. The ears analyzed at steady state were divided into 2 groups: ETS<7 group and ETS≥ 7 group. The same division was applied for the ears analyzed after the Valsalva maneuver: ETS<7 group and ETS≥ 7 group. ETs were categorized as “well defined” (WD) and “not defined” (ND). The results of the analysis of the ETS-7 score in all 24 ears showed that 42% presented ETS ≥7, while 58% had ETS <7, indicating a diagnosis of ETD. In the ETS<7 group after Valsalva, ET was visualized in 33% of patients. In the ETS≥7 group it was WD in 29% after the Valsalva manoeuver. In both groups the comparison between the visualization of the ET before and after the Valsalva manoeuver did not present a statistical difference. No correlation emerged between ET evaluation with CT scan during Valsalva maneuver and ETS-7 score. It confirms that there is not a gold standard for the study of ET dysfunction.

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