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

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.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215118000014 ◽

2018 ◽

Vol 132 (2) ◽

pp. 111-116 ◽

Cited By ~ 6

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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Refractory otitis media with effusion from viewpoints of eustachian tube dysfunction and nasal sinusitis

American Journal of Otolaryngology ◽

10.1016/0196-0709(93)90028-6 ◽

1993 ◽

Vol 14 (3) ◽

pp. 187-190 ◽

Cited By ~ 20

Author(s):

Akihiko Fujita ◽

Iwao Honjo ◽

Kyosuke Kurata ◽

I-Ken Gan ◽

Haruo Takahashi

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Otitis Media With Effusion ◽

Eustachian Tube Dysfunction ◽

Tube Dysfunction

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Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215117000482 ◽

2017 ◽

Vol 131 (5) ◽

pp. 411-416 ◽

Cited By ~ 1

Author(s):

P M Picciotti ◽

G Della Marca ◽

L D'Alatri ◽

D Lucidi ◽

M Rigante ◽

...

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Muscle Activity ◽

Muscle Dysfunction ◽

Non Invasive ◽

Muscle Action Potential ◽

Before And After ◽

Middle Ear Ventilation ◽

Tube Dysfunction ◽

Tensor Veli Palatini Muscle

AbstractBackground:The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing.Methods:Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed.Results:In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation.Conclusion:This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.

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

Otolaryngology ◽

10.1016/j.otohns.2007.02.016 ◽

2007 ◽

Vol 137 (2) ◽

pp. 321-326 ◽

Cited By ~ 5

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.

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

PLoS ONE ◽

10.1371/journal.pone.0247708 ◽

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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An alternative treatment approach for patients with resistant otitis media with effusion and dysfunctional Eustachian tube: A pilot study with rapid maxillary expansion

The Angle Orthodontist ◽

10.2319/021421-127.1 ◽

2021 ◽

Author(s):

Nihat Kılıç ◽

Özgür Yörük ◽

Songül Cömert Kılıç

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Otitis Media With Effusion ◽

Rapid Maxillary Expansion ◽

Eustachian Tube Dysfunction ◽

Control Group ◽

Maxillary Expansion ◽

Tube Dysfunction ◽

Maxillary Constriction ◽

Observation Period

ABSTRACT Objectives To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). Materials and Methods The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. Results In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P > .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P < .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). Conclusions The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.

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

Ear Nose & Throat Journal ◽

10.1177/014556130308200110 ◽

2003 ◽

Vol 82 (1) ◽

pp. 28-32 ◽

Cited By ~ 12

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.

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An easier way of inserting the Shah permavent grommet

The Journal of Laryngology & Otology ◽

10.1258/0022215053222798 ◽

2005 ◽

Vol 119 (1) ◽

pp. 36-37 ◽

Cited By ~ 3

Author(s):

J Tahery ◽

S R Saeed

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Otitis Media With Effusion ◽

Eustachian Tube Dysfunction ◽

Ventilation Tube ◽

Tube Insertion ◽

Simple Modification ◽

Tube Dysfunction ◽

Long Term Ventilation

Ventilation tube insertion plays an important role in the management of otitis media with effusion. In selected cases, repeated grommet insertion due to persistent eustachian tube dysfunction necessitates the need for longer-term ventilation. Insertion of such tubes can however occasionally be more difficult than insertion of standard grommets. One such long-term ventilation tube is the Shah permavent grommet. This paper describes a simple modification of the technique that is less time-consuming and less traumatic.

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