scholarly journals Direct Application of Dexamethasone for the Treatment of Chronic Eustachian Tube Dysfunction

2003 ◽  
Vol 82 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Herbert Silverstein ◽  
Joshua P. Light ◽  
Lance E. Jackson ◽  
Seth I. Rosenberg ◽  
Jack H. Thompson
Keyword(s):  
Eustachian Tube ◽  
Eustachian Tube Dysfunction ◽  
Speech Discrimination ◽  
Pressure Equalization ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction ◽  
Direct Administration ◽  
The Mean ◽  
Samter’S Triad ◽  
A Prospective Study

We undertook a prospective study to determine the safety and effectiveness of the direct administration of a steroid to the eustachian tube via the Silverstein MicroWick in 11 patients with chronic eustachian tube dysfunction, including two who had Samter's triad. All patients had previously been treated with medical therapy and surgical middle ear ventilation without resolution. The MicroWick was placed directly in the eustachian tube orifice through a pressure-equalization tube. Patients received 3 drops of dexamethasone 4 mg/ml three times a day. The drops were discontinued after 4 weeks, and the MicroWick and ventilation tube were removed after 3 months. At study's end, eight patients (72.7%) reported subjective improvement in terms of a reduction in aural pressure and fullness. Audiometric testing demonstrated a 55% reduction in the mean air-bone gap and a 3% increase in the mean speech discrimination score. Bone pure-tone averages remained stable. Tympanometry showed that five patients (45.5%) converted from type B or C tympanograms to type A. Four patients (36.4%) had persistent perforations. Both patients with Samter's triad improved with therapy. These preliminary results suggest that direct dexamethasone administration to the eustachian tube is safe and effective for the treatment of chronic eustachian tube dysfunction. Long-term studies to confirm these findings are under way.

scholarly journals Eustachian Tube Dysfunction in Children With Adenoid Hypertrophy: The Role of Adenoidectomy for Improving Ear Ventilation

2021 ◽  
pp. 014556132198945
Author(s):  
Alessandra Manno ◽  
Giannicola Iannella ◽  
Vincenzo Savastano ◽  
Tommaso Vittori ◽  
Serena Bertin ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Preoperative Evaluation ◽  
Mean Value ◽  
Eustachian Tube Dysfunction ◽  
Adenoid Hypertrophy ◽  
Before And After ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction ◽  
The Impact

Introduction: To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). Aim: The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Methods: Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Results: Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value ( P = .0015). Conclusions: Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation.

Eustachian Tube Quality of Life and Severity of Disease in Patients With Chronic Rhinosinusitis

2020 ◽  
Vol 34 (4) ◽  
pp. 532-536 ◽  
Author(s):  
Arthur W. Wu ◽  
Evan S. Walgama ◽  
Thomas S. Higgins ◽  
Michela Borrelli ◽  
Narine Vardanyan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Eustachian Tube ◽  
Correlation Coefficients ◽  
Eustachian Tube Dysfunction ◽  
Spearman Correlation ◽  
Tube Dysfunction ◽  
The Mean ◽  
Snot 22

Background Chronic rhinosinusitis (CRS) has long been a suspected risk factor for Eustachian tube dysfunction (ETD). However, there have been few studies quantifying the presence of ETD in CRS patients. We sought to determine the prevalence of ETD symptoms in patients undergoing functional endoscopic sinus surgery (FESS) for CRS using the validated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and to correlate the ETDQ-7 scores with scores of CRS symptom severity based on the 22-item Sino-Nasal Outcome Test (SNOT-22). Methods Patients for FESS were preoperatively administered both the ETDQ-7 and the SNOT-22 validated quality of life instruments. Pearson and Spearman correlation coefficients were calculated. Changes in ETDQ-7 were measured at 3 months and differences were compared via paired t test. Results A total of 82 patients completed the surveys. Thirty-nine (47.6%) patients had ETDQ-7 score ≥14.5, signifying clinically significant ETD symptoms. The mean ETDQ-7 score of the study population was 15.8 ± 8.8, and the mean SNOT-22 score was 37.5 ± 19.7. The Pearson and Spearman correlation coefficients between ETDQ-7 and the total SNOT-22 score were 0.52 ( P > .0001) and 0.51 ( P < .0001), respectively. There was significant improvement in ETDQ-7 scores postoperatively. Conclusion While the association between ETD and CRS has long been known, this is one of the few prospective patient studies evaluating otologic symptoms in a CRS population. We found that a significant percentage of CRS patients suffer from ETD symptoms based on patient-reported subjective outcome measures. This study demonstrates that otologic symptoms increase with CRS severity and improve after FESS.

scholarly journals Can Lateral Nasopharyngeal Radiographs be used to Predict Eustachian Tube Dysfunction?

2017 ◽  
Vol 96 (8) ◽  
pp. E1-E5
Author(s):  
Karen Hawley ◽  
Neil Vachhani ◽  
Samantha Anne
Keyword(s):  
Eustachian Tube ◽  
Cranial Base ◽  
Eustachian Tube Dysfunction ◽  
Receiver Operating Curve ◽  
Individual Measurement ◽  
Pressure Equalization ◽  
Anterior Cranial Base ◽  
Tube Dysfunction ◽  
Study Population ◽  
Craniofacial Features

The objective of our case-control study was to determine whether craniofacial features on lateral nasopharyngeal radiographs (LNPRs) can predict eustachian tube dysfunction (ETD). The study included patients seen in the otolaryngology clinic from 2005 to 2011. Patients 0 to 10 years old with pressure equalization tube (PET) placement and LNPR within 6 months were included. Measurements were compared with age-matched controls selected at random to identify craniofacial features associated with ETD. Using receiver operating curve methodology, selected measurements were used to correlate age, craniofacial features, and ETD. The study population consisted of 32 patients and 34 controls. No significant differences were found between groups on any individual measurement: cranial base angle; lengths of anterior, middle, and total skull base; mandible; hard and soft palates; sella–soft-palate tip; sella-posterior nasal spine; and nasopharyngeal and palatal airway. Further statistical analysis demonstrated that patients who required PETs were more likely to have shortened anterior cranial base and maxilla relative to mandibular length. Contrary to the findings of previous studies, no single measurement was found to identify craniofacial features that may select for children with ETD requiring PETs. However, younger patients with a smaller cranial base and/or maxilla relative to mandibular length are more likely to require PETs, implying persistent ETD.

scholarly journals Development of biodegradable stents for the treatment of Eustachian tube dysfunction

2018 ◽  
Vol 4 (1) ◽  
pp. 505-508
Author(s):  
Kerstin Schümann ◽  
Tamara Wilfling ◽  
Gerrit Paasche ◽  
Robert Schuon ◽  
Schuon Robert ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Target Location ◽  
Eustachian Tube Dysfunction ◽  
In Vitro Tests ◽  
Elastic Recoil ◽  
Requirements Specifications ◽  
Biodegradable Stents ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction

AbstractTo provide an effective and safe therapy for chronic Eustachian tube dysfunction (ETD), biodegradable stents should be developed to restore important functions, e.g. middle ear ventilation and drainage. After defining general requirements specifications, stent designs of cardiovascular polymeric stents were modified according to dimensions and conditions of the Eustachian tube. Finite element simulations demonstrated the crimping capacity of the developed stent design and the ability of expansion in the specific geometry of the target location. Subsequent in vitro tests of stent prototypes showed satisfying properties concerning crimpability, expansion behavior and elastic recoil to demonstrate general feasibility. Further developments and additional testing will advance the implementation of a new treatment option of ETD.

Middle Ear Ventilation with HydroxylVent Tube: Review of the Initial Series

1993 ◽  
Vol 108 (6) ◽  
pp. 701-705 ◽  
Author(s):  
Anthony F. Jahn
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Conventional Ventilation ◽  
Eustachian Tube Dysfunction ◽  
Initial Series ◽  
Prolonged Ventilation ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction ◽  
Ventilation Tubes

Thirty HydroxylVent tubes were implanted in twenty-seven patients. The chief Indications were unresolving eustachian tube dysfunction, with either collapse or perforation of the tympanic membrane. Every patient had undergone a lengthy course of treatment with conventional ventilation tubes. Twenty ears (66%) showed good results, with prolonged ventilation and restoration of middle ear function. Two tubes appeared to be open, with the development of a pinpoint perforation of the drum. Eight tubes occluded as a result of displacement of the tube, middle ear pathology, or debris. Indications and techniques of management are discussed, along with an analysis of complications.

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.

scholarly journals Effect of head and neck radiotherapy on the Eustachian tube functions

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmed Abdullah Hamd ◽  
Essam Abd El-Wanes Behiry ◽  
Adel Tharwat Atallah ◽  
Sherif Maher Elaini ◽  
Ahmed Hamdy Alshafai
Keyword(s):  
Head And Neck ◽  
Eustachian Tube ◽  
Contralateral Side ◽  
Head And Neck Tumors ◽  
Eustachian Tube Dysfunction ◽  
Middle Ear Effusion ◽  
Neck Tumors ◽  
Tube Dysfunction ◽  
Ear Effusion

Abstract Background Nowadays, radiotherapy is widely used in management of many types of tumors including head and neck tumors; in this study, we concerned with its reverse effects on the Eustachian tube functions and if this effect is temporary or permanent. Results The whole (30) patients have tympanogram at both ears before starting radiotherapy; all patients (100%) were normal. In the immediate post radiotherapy tympanogram at the contralateral side, 6.7% of patients had effusion, and 20% had Eustachian tube dysfunction, while at the ipsilateral side, 20% of patients had effusion, and 33.3% had ET dysfunction. In the follow-up tympanogram 12 weeks post radiotherapy, we found that 6.7% of patients had effusion, and (10%) had Eustachian tube dysfunction at the contralateral side, while 6.7% of patients had effusion, and only 20% had Eustachian tube dysfunction at the ipsilateral side. Conclusion From this study, we concluded that patients with head and neck tumors treated by radiotherapy (apart from the nasopharynx) have a high incidence of affection of Eustachian tube function namely middle ear effusion and Eustachian tube dysfunction. The possibility for development of middle ear effusion and Eustachian tube dysfunction increases with increased tumor stage. Eustachian tube functions immediately post radiotherapy and after 12 weeks of the end of radiotherapy was affected by different effects according to the tumor site. The Eustachian tube functions significantly improved within 12 weeks after the last dose of radiotherapy, and we recommend audiological follow-up for patients with head and neck tumors treated with radiotherapy.

Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients

2018 ◽  
Vol 132 (2) ◽  
pp. 111-116 ◽  
Author(s):  
K Akazawa ◽  
H Doi ◽  
S Ohta ◽  
T Terada ◽  
M Fujiwara ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Otitis Media With Effusion ◽  
Intensity Modulated Radiotherapy ◽  
Eustachian Tube Dysfunction ◽  
Dose Volume ◽  
Tube Dysfunction ◽  
The Relationship ◽  
Higher Doses

AbstractObjective:This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.Methods:The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.Results:Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.Conclusion:The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

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