Eustachian Tube Function in Cleft Palate Children

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 34-40 ◽  
Author(s):  
William J. Doyle ◽  
Erdem I. Cantekin ◽  
Charles D. Bluestone
Keyword(s):  
Cleft Palate ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Forced Response ◽  
Eustachian Tube Function ◽  
High Prevalence ◽  
Tube Function ◽  
Negative Pressures ◽  
Perforation Group

The cleft palate population has a high prevalence of chronic otitis media with effusion (OME). The present study attempts to relate this pathology to a functional obstruction of the eustachian tube (ET). Employing two methods, the forced-response test and the inflation-deflation test, various parameters of ET function were evaluated in 41 children and adolescents with cleft palates. The results indicated that cleft palate children have a limited ability to open the ET actively by swallowing, as evidenced by an inability to equilibrate applied positive or negative pressures. These children demonstrated little ability to alter pressure in the middle ear (ME) by either the Valsalva or Toynbee maneuver. Passive ET airflow resistance in these children is not different from that of a traumatic perforation group. However, in the majority of cases (73%), the resistance of the tube increased with swallowing, suggesting a constriction of the ET rather than a dilation. Further, for those individuals capable of tubal dilation, the efficiency of dilation as measured by the resistance ratio was significantly less than that reported for the traumatic perforation group. Eustachian tube function in this population was not demonstrably dependent on age, sex, or type of cleft. The cleft palate children of the present study had severe functional obstruction of the ET. This obstruction was primarily related to the inability of the tensor veli palatini (TVP) muscle to dilate the ET actively during swallowing and appears to be the major factor responsible for the pathogenesis of OME in this population.

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

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 47-54 ◽  
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.

Comparison of Normal Eustachian Tube Function in the Rhesus Monkey and Man

1982 ◽  
Vol 91 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Erdem I. Cantekin ◽  
William J. Doyle ◽  
Charles D. Bluestone
Keyword(s):  
Rhesus Monkey ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Rhesus Monkeys ◽  
Otitis Media With Effusion ◽  
Human Subjects ◽  
Forced Response ◽  
Eustachian Tube Function ◽  
Suitable Animal Model ◽  
Tube Function

Employing inflation-deflation and forced-response tests, the eustachian tube (ET) function was evaluated in six adult human subjects with traumatic perforations of the tympanic membrane and otherwise negative otologic histories; and 15 juvenile or adult rhesus monkeys with freshly created myringotomy perforations of the tympanic membrane and otherwise documented normal middle ears. The study findings demonstrated that the rhesus monkey ET functions as a scaled down model of the ET of man, exhibiting a shorter tubal dilation duration and a lesser capacity to pass air. When ET function in the two species was compared using a dimensionless measure expressing the tubal dilation efficiency, the operational biomechanics of both systems were found to be almost identical. These observed functional homologies between man and the rhesus monkey ET systems suggest that the rhesus monkey is a suitable animal model in which to study the pathogenesis of otitis media with effusion, stemming from ET dysfunction.

A Comparison of the Effects of Veau-Wardill-Kilner Palatoplasty and Furlow Double-Opposing Z-Plasty Operations on Eustachian Tube Function

2000 ◽  
Vol 37 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Ethem Güneren ◽  
Zafer Özsoy ◽  
Mithat Ulay ◽  
Erhan Eryilmaz ◽  
Haluk Özkul ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Eustachian Tube ◽  
Soft Palate ◽  
Surgical Anatomy ◽  
Eustachian Tube Function ◽  
Secretory Otitis Media ◽  
Significant Difference ◽  
Before And After ◽  
Tube Function

Objective The purpose of this study was to compare the effects of Veau-Wardill-Kilner (VWK) two-flap palatoplasty and Furlow double-opposing Z-plasty operations on eustachian tube (ET) opening in patients with cleft palate (CP). Design Twenty-six patients underwent CP repair between 1993 and 1997. VWK and Furlow operations were used in 13 patients each. All patients were examined by the otorhinolaryngologist before and after the operations; mean follow-up time was 27.3 months. Secretory otitis media (SOM), as identified by tympanograms, was the comparison criterion used. Results The prevalence of SOM was 69% (n = 18) in all CP patients pre-operatively. Among those with preoperative SOM, we did not find any statistically significant difference in the frequency of postoperative SOM between the two techniques. Conclusion This study suggests that there is no difference in postoperative ET function between patients undergoing either VWK or Furlow operations, in spite of the differences in muscle positioning in these operations. We discuss the implications of this finding in relation to surgical anatomy and histology of the soft palate muscles.

scholarly journals Eustachian tube function in chronic otitis media.

1987 ◽  
Vol 80 (3) ◽  
pp. 379-384
Author(s):  
Masahiko Hayashi ◽  
Hiroaki Sato ◽  
Etsuo Yamamoto ◽  
Iwao Honjo
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Chronic Otitis Media ◽  
Eustachian Tube Function ◽  
Tube Function
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