A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test

In order to clarify the cause of the constriction of the eustachian tube during swallowing that is often seen in patients with otitis media with effusion, video endoscopy of the pharyngeal orifice of the eustachian tube was performed and superimposed with videograms of the tubal airflow and resistance, which were simultaneously examined by the forced response test. In children with otitis media with effusion (17 ears), when the eustachian tube constricted on the videogram on swallowing, the tubal orifice was found to be squeezed between an elevated soft palate and a hypertrophied adenoid (7/17), squeezed between an elevated soft palate and edema of the posterior lip (7/17), or blocked by nasal discharge (5/17). In adults with otitis media with effusion (7 ears), edema of the posterior lip (5/7) was the main cause of the constriction of the tubal orifice during swallowing. Inflammation in the nasopharynx and the pharyngeal portion of the eustachian tube was considered to be closely related to the tubal constriction, which represents a considerable part of the cause of tubal ventilatory dysfunction in otitis media with effusion.

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Timing of tensor and levator veli palatini force application determines eustachian tube resistance patterns during the forced-response test

Auris Nasus Larynx ◽

10.1016/j.anl.2010.02.008 ◽

2010 ◽

Vol 37 (6) ◽

pp. 720-729 ◽

Cited By ~ 10

Author(s):

Samir N. Ghadiali ◽

E. David Bell ◽

J. Douglas Swarts

Keyword(s):

Eustachian Tube ◽

Forced Response ◽

Response Test ◽

Levator Veli Palatini ◽

Force Application ◽

Resistance Patterns

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535 Evaluation of the Human Eustachian Tube Function by the Forced-Response Test

The Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME ◽

10.1299/jsmebio.2005.18.369 ◽

2006 ◽

Vol 2005.18 (0) ◽

pp. 369-370

Author(s):

Shinji HAMANISHI ◽

Kenichi ABE ◽

Mitsuki SUGAYA ◽

Tetsuaki KAWASE ◽

Toshimitsu KOBAYASHI ◽

...

Keyword(s):

Eustachian Tube ◽

Forced Response ◽

Eustachian Tube Function ◽

Response Test ◽

Tube Function

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Compliance of the Patulous Eustachian Tube

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949310200206 ◽

1993 ◽

Vol 102 (2) ◽

pp. 110-112 ◽

Cited By ~ 10

Author(s):

Junji Sakakihara ◽

Iwao Honjo ◽

Kyosuke Kurata ◽

Akihiko Fujita ◽

Haruo Takahashi

Keyword(s):

Eustachian Tube ◽

Forced Response ◽

Opening Pressure ◽

Passive Resistance ◽

Response Test ◽

Patulous Eustachian Tube

The compliance and ventilatory functions of the eustachian tube (ET) of 17 ears with patulous ETs were examined and compared to those of 16 ears with traumatic perforation of the eardrum (controls) by means of the tubal compliance test, the inflation-deflation test, and the forced response test. The tubal compliance was significantly lower in the patulous ETs than in the controls. An excessive patency of the ET was confirmed among the patients with patulous ETs by a low opening pressure during the inflation test and a low passive resistance on the forced response test. Active ventilatory dysfunction was also found to be significantly more common in the patulous ETs by the deflation test and the measure of dilation efficiency. These results indicated that the ET appeared to be rather rigid and less moveable when patulous than when normal.

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Measurement of the viscoelastic compliance of the eustachian tube using a modified forced-response test

Auris Nasus Larynx ◽

10.1016/s0385-8146(01)00116-x ◽

2002 ◽

Vol 29 (1) ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Samir N Ghadiali ◽

William J Federspiel ◽

J.Douglas Swarts ◽

William J Doyle

Keyword(s):

Eustachian Tube ◽

Forced Response ◽

Response Test

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Salvage Eustachian Tube Cartilage Chip Insertion After Multiple Transnasal Shim Operations in Intractable Patulous Eustachian Tube

Ear Nose & Throat Journal ◽

10.1177/0145561321995009 ◽

2021 ◽

pp. 014556132199500

Author(s):

Wei-Ting Lee ◽

Heng-Jui Hsu

Keyword(s):

Surgical Technique ◽

Eustachian Tube ◽

Middle Ear ◽

Repeat Surgery ◽

Ear Infection ◽

Middle Ear Infection ◽

Tube Lumen ◽

Management Method ◽

Patulous Eustachian Tube

This article presents 2 cases of extremely intractable patulous Eustachian tube following multiple transnasal shim insertion. These cases highlight the disadvantages of repeat transnasal shim operations, including enlargement of the Eustachian tube lumen, frequent dislocation, repeat surgery, recurrent middle ear infection, and shim misswallowing. The patients in these cases were successfully treated with Eustachian tube cartilage chip insertion through a postauricular approach. We describe the surgical technique and advantages of this promising management method.

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Effect of Surgical Alterations of the Tensor Veli Palatini Muscle onc Eustachian Tube Function

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800890s313 ◽

1980 ◽

Vol 89 (3_suppl) ◽

pp. 47-54 ◽

Cited By ~ 48

Author(s):

Erdem I. Cantekin ◽

David C. Phillips ◽

Charles D. Bluestone ◽

William J. Doyle ◽

Kyle K. Kimes

Keyword(s):

Eustachian Tube ◽

Otitis Media With Effusion ◽

Forced Response ◽

Eustachian Tube Function ◽

Complete Excision ◽

Function Tests ◽

Short Period ◽

Tube Function ◽

Tensor Veli Palatini Muscle ◽

One Year

Previous studies in humans have indicated that functional obstruction of the eustachian tube (ET) is an important factor in the pathogenesis of otitis media with effusion (OME). This type of obstruction appears to be related to the structural properties of the tube, or to an inefficient active tubal opening mechanism, or both. In this study, functional ET obstruction was created in 22 rhesus monkeys ( Macaca mulatta) by surgically altering the tensor veli palatini (TVP) muscle using three different procedures: 1) complete excision of the muscle; 2) transection of the superficial muscle bundle; or 3) transposition of the muscle tendon medial to the hamular process. Prior to surgery, weekly tympanometry, pneumatic otoscopy, and otomicroscopic examinations were performed for a period of at least six months to document middle ear (ME) status. A minimum of four ET function tests were performed on each animal using the inflation-deflation and forced-response tests. Following surgery, these tests and examinations were continued for periods of up to one year. Postoperatively, the animals in which the TVP had been excised developed a sterile ME effusion which proved to be a chronic condition which persisted throughout the follow-up period. Eustachian tube function tests showed a complete absence of any active tubal dilation by swallowing. Animals that had the muscle transected developed abnormal ME pressures, or effusions, or both, which returned to normal in some ears, but which were recurrent or chronic in others. Eustachian tube function tests in these animals showed an initial loss of active tubal function which gradually improved, but not to normal levels, presumably as a result of healing of the muscle. In cases in which the muscle was transposed the ME pathology and ET dysfunction were similar after the surgery, but improved within a short period of time. These data suggest that alteration of the TVP muscle can create functional obstruction of the ET. The severity of ET obstruction depends upon the surgical procedure undertaken. The results of postoperative ET function tests were similar to those recorded from children with recurrent and chronic OME.

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