Anatomical Effects of Sudden Middle Ear Pressure Changes

1979 ◽  
Vol 88 (3) ◽  
pp. 368-376 ◽  
Author(s):  
A. Axelsson ◽  
J. Miller ◽  
M. Silverman
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Round Window ◽  
Applied Pressure ◽  
Positive Pressure ◽  
Air Bubbles ◽  
Scala Tympani ◽  
Middle Ear Pressure ◽  
Contralateral Ear ◽  
Pressure Changes

Acute middle ear (ME) and inner ear changes following brief unilateral phasic ME pressure changes (up to ± 6000/mm H2O) were studied in the guinea pig. Middle ear findings included perforation of the tympanic membrane, serous and serosanguinous exudate and hemorrhage of tympanic membrane and periosteal vessels. Changes were related to magnitude of applied pressure. Perforation and hemorrhage were more commonly seen with negative rather than positive pressure. Air bubbles behind the round window were seen with positive pressures. Occasional distortion, but never perforation of the round window, was noted. Hemorrhage of the scala tympani was observed with both positive and negative pressures; scala vestibuli hemorrhage was found with negative ME pressure. In some instances pressure direction and magnitude related changes were seen in the contralateral ear.

Detection of tympanic membrane movement using film patch with integrated strain gauge, assessed by optical coherence tomography: experimental study

2011 ◽  
Vol 125 (5) ◽  
pp. 467-473 ◽  
Author(s):  
T Just ◽  
T Zehlicke ◽  
O Specht ◽  
W Sass ◽  
C Punke ◽  
...  
Keyword(s):  
Experimental Study ◽  
Optical Coherence Tomography ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Strain Gauge ◽  
Ex Vivo ◽  
Optical Coherence ◽  
Middle Ear Pressure ◽  
Pressure Changes

AbstractObjective:We report an ex vivo and in vivo experimental study of a device designed to measure tympanic membrane movement under normal and pathological conditions, assessed using optical coherence tomography.Materials and methods:We designed two types of flexible, round film patch with integrated strain gauge, to be attached to the tympanic membrane in order to measure tympanic membrane movement. Tympanic membrane attachment was assessed using optical coherence tomography. The devices were tested experimentally using an ex vivo model with varying middle-ear pressure.Results:Optical coherence tomography reliably assessed attachment of the film patch to the tympanic membrane, before and after middle-ear pressure changes. Strain gauge voltage changes were directly proportional to middle-ear pressure recordings, for low pressure changes. Tympanic membrane perforations smaller than 2 mm could be sealed off with the film patch.Conclusion:Attachment of the film patch with integrated strain gauge to the tympanic membrane was not ideal. Nevertheless, the strain gauge was able to precisely detect small pressure changes within the middle ear, in this experimental model.

Applied comparative physiology of the avian middle ear: the effect of static pressure changes in columellar ears

2006 ◽  
Vol 120 (12) ◽  
pp. 1005-1007 ◽  
Author(s):  
R Mills ◽  
J Zhang
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Static Pressure ◽  
Protective Mechanism ◽  
Comparative Physiology ◽  
Middle Ear Pressure ◽  
Human Middle Ear ◽  
Pressure Changes

We investigated the motion of the single ossicle found in the middle ears of four different species of birds. In the avian middle ear, the off centre attachment of the extracolumella to the tympanic membrane and the flexion of the joint between the extracolumella and columella results in rocking of the footplate rather than direct excursion in and out of the vestibule. We postulate that this is a protective mechanism to avoid excessive displacement of the footplate into the vestibule during changes in middle-ear pressure and that it is analogous to the ossicular ‘decoupling’ observed in the human middle ear in the same circumstances.

Observations of Middle Ear Pressures

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 56-60 ◽  
Author(s):  
Richard A. Buckingham ◽  
Jose L. Ferrer
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Motion Picture ◽  
Saline Solution ◽  
Positive Pressure ◽  
Motion Picture Film ◽  
Sterile Saline ◽  
Tympanic Membrane Perforations ◽  
Middle Ear Pressure ◽  
Direct Measurements

Previous direct measurements of middle ear pressure in ears with serous otitis resulted in the range of from 0 to − 10 mm H2O pressure. To confirm these findings we attempted to quantify middle ear pressures by doing myringotomies in serous otitis patients through sterile saline solution. We compared the rate of aspiration of the saline in ears with serous otitis to the rate of aspiration of saline after an experimental myringotomy in an ear model in which known pressures were imposed. To record our findings we used motion picture photography. Layering a film of sterile oil suspension of oxytetracycline and hydrocortisone over dry tympanic membrane perforations resulted in the demonstration of a pulsatile positive pressure of about 6 mm water in many of the ears which we tested. The oil film often formed an external bubble which ruptured after several minutes. In some ears there was no change in pressure and in only a small percentage there was evidence of a decreased pressure by absorption of air in the middle ear during the period of observation. This positive pressure is unrelated to swallowing and suggests that the current theories of middle ear aeration via opening of the eustachian tube may not be valid. These findings were demonstrated with motion picture film.

Chronic Effects of Phasic Middle Ear Pressure Changes

1981 ◽  
Vol 90 (3) ◽  
pp. 281-286 ◽  
Author(s):  
J. M. Miller ◽  
A. Axelsson ◽  
W. Potter
Keyword(s):  
Inner Ear ◽  
Middle Ear ◽  
Negative Pressure ◽  
Round Window ◽  
Pressure Change ◽  
Positive Pressure ◽  
Tympanic Membrane Perforations ◽  
Middle Ear Pressure ◽  
Reported Study ◽  
Membrane Changes

In an attempt to better define the mechanisms of barotrauma, middle and inner ear pathology was studied in guinea pigs three weeks following exposure to a brief, sudden middle ear pressure change. Findings included tympanic membrane perforations (particularly dependent upon high negative pressure exposures), vascular hemorrhage (primarily dependent upon high positive pressure exposures), serosanguineous effusions (predominantly dependent upon infection) and serous effusion (dependent upon negative pressure exposure). Round window perforations were common in high pressure animals with infection. Other inner ear membrane changes were infrequent or minimal. Lymphatic hemorrhage was observed as a function of exposure. The clinical implications of these findings and possible mechanisms underlying these changes are discussed in terms of our previously reported study of the immediate effects of such pressure chance.

Study of Toynbee Phenomenon by Combined Intranasopharyngeal and Tympanometric Measurements

1988 ◽  
Vol 97 (2) ◽  
pp. 199-206 ◽  
Author(s):  
Yehuda Finkelstein ◽  
Yuval Zohar ◽  
Yoav P. Talmi ◽  
Nelu Laurian
Keyword(s):  
Middle Ear ◽  
Negative Pressure ◽  
Pressure Change ◽  
Positive Pressure ◽  
New Information ◽  
Pressure Changes ◽  
Rapid Pressure

The Toynbee maneuver, swallowing when the nose is obstructed, leads in most cases to pressure changes in one or both middle ears, resulting in a sensation of fullness. Since first described, many varying and contradictory comments have been reported in the literature concerning the type and amount of pressure changes both in the nasopharynx and in the middle ear. In our study, the pressure changes were determined by catheters placed into the nasopharynx and repeated tympanometric measurements. New information concerning the rapid pressure variations in the nasopharynx and middle ear during deglutition with an obstructed nose was obtained. Typical individual nasopharyngeal pressure change patterns were recorded, ranging from a maximal positive pressure of + 450 to a negative pressure as low as −320 mm H2O.

Common drugs used in ENT

2009 ◽  
pp. 347-350
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Inner Ear ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Otitis Externa ◽  
Round Window ◽  
Acid Reflux ◽  
Tympanic Membrane Perforation ◽  
Active Infection ◽  
Middle Ear Mucosa ◽  
Membrane Perforation

Drugs used in the ear 348 Drugs used in the nose 349 Drugs used in the treatment of acid reflux 350 This group of drugs is widely used for the treatment of otitis externa. Otitis externa 2 drops tds for 10 days Presence of grommet or tympanic membrane perforation due to aminoglycoside ototoxicity in the inner ear. Risk thought to be low in the presence of active infection where the middle-ear mucosa is swollen and the antibiotic is unlikely to reach the inner ear via the round window...

Rupture of the round Window Membrane

1976 ◽  
Vol 85 (1) ◽  
pp. 105-110 ◽  
Author(s):  
P. H. Taylor ◽  
P. G. Bicknell
Keyword(s):  
Middle Ear ◽  
Surgical Intervention ◽  
Round Window ◽  
Oval Window ◽  
Round Window Membrane ◽  
Physical Effort ◽  
Cochlear Aqueduct ◽  
Definite Improvement ◽  
History Of ◽  
Pressure Changes

A case of sudden deafness due to rupture of the round window membrane is presented. Nineteen similar cases have previously been reported in the literature. In a review of these twenty patients, it is noted that a history of concurrent physical effort or barotrauma was present in eighteen. This supports the view that the injury is produced by pressure changes acting either along the cochlear aqueduct (the explosive route) or, directly on the middle ear structures (the implosive route). At operation, the rupture may be difficult to see, and a separate leak from the oval window may be present. The timing of any surgical intervention is important. The authors recommend that this should be deferred for one week after the onset of symptoms, as the fistula may heal spontaneously. If no definite improvement has occurred at the end of this time, then tympanotomy should be undertaken during the next week.

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