Evacuation of the Middle Ear by Sniffing: A Cause of High Negative Pressure and Development of Middle Ear Disease

1984 ◽  
Vol 92 (3) ◽  
pp. 312-318 ◽  
Author(s):  
Bernt Falk ◽  
Bengt Magnuson
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Negative Pressure ◽  
Experimental Studies ◽  
Eustachian Tube Function ◽  
Middle Ear Effusion ◽  
Pressure Equalization ◽  
Tube Function ◽  
Middle Ear Disease ◽  
Ear Effusion

Previous research on eustachian tube function has been devoted mainly to the study of the tubal opening ability and pressure equalization. This article summarizes a series of experimental studies focusing on the closing ability of the tube. Results support the belief that the purpose of the tube should be seen primarily as protecting the middle ear from the extensive pressure variations that physiologically take place in the nasopharynx. A number of studies of diseased ears have shown that tubal malfunction was characterized mainly by a reduced ability to withstand negative pressure in the nasopharynx. Sniffing can evacuate the middle ear, causing high negative intratympanic pressure. It seems likely that this mechanism is involved in the development of middle ear effusion and manifest retraction-type middle ear disease.

scholarly journals PO2 in Middle Ear Effusion and Eustachian Tube Function

1988 ◽  
Vol 1988 (Supplement20) ◽  
pp. 1-7 ◽  
Author(s):  
Hideto Niwa ◽  
Masakatsu Takahashi ◽  
Hiromi Ueda ◽  
Noriyuki Yanagita
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Function ◽  
Middle Ear Effusion ◽  
Tube Function ◽  
Ear Effusion

scholarly journals Eustachian tube function as a predictor of the recurrence of middle ear effusion in children

2013 ◽  
Vol 123 (9) ◽  
pp. 2285-2290 ◽  
Author(s):  
Ellen M. Mandel ◽  
J. Douglas Swarts ◽  
Margaretha L. Casselbrant ◽  
Kathleen K. Tekely ◽  
Beverly C. Richert ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Function ◽  
Middle Ear Effusion ◽  
Tube Function ◽  
Ear Effusion

Effect of nasal packing on Eustachian tube function

1991 ◽  
Vol 105 (7) ◽  
pp. 539-540 ◽  
Author(s):  
A. C. Thompson ◽  
J. A. Crowther
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Nasal Packing ◽  
Eustachian Tube Function ◽  
Middle Ear Effusion ◽  
Middle Ear Pressure ◽  
Septal Surgery ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Ear Effusion

AbstractSixty-three patients undergoing surgery to the nasal septum followed by bilateral packing had pre- and post-operative tympanometry in order to determine the effect on eustachian tube function. Fifty-five of the 126 ears tested (46 per cent) developed a reduction in middle ear pressure of at least 50 daPa; 76 per cent became normal within 24 hours of removing the nasal packs. All ears were asymptomatic and no patient had evidence of middle ear effusion. Nasal packing following septal surgery is a frequent cause of shortlasting eustachian tube dysfunction but rarely severe enough to cause symptoms or middle ear effusion. Tubal dysfunction is most likely due to a combination of surgical oedema and a direct effect of the nasal packing.

scholarly journals Eustachian Tube Function in Adults without Middle Ear Disease

2011 ◽  
Vol 120 (4) ◽  
pp. 220-225 ◽  
Author(s):  
J. Douglas Swarts ◽  
Cuneyt M. Alper ◽  
Ellen M. Mandel ◽  
Richard Villardo ◽  
William J. Doyle
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Function ◽  
Tube Function ◽  
Middle Ear Disease

Comparative Preoperative Evaluation of Eustachian Tube Function in Pathological Ears

1980 ◽  
Vol 89 (4) ◽  
pp. 366-369 ◽  
Author(s):  
H. Virtanen ◽  
T. Palva ◽  
T. Jauhiainen
Keyword(s):  
Eustachian Tube ◽  
Negative Pressure ◽  
Preoperative Evaluation ◽  
Tympanic Membrane Perforation ◽  
Eustachian Tube Function ◽  
Pressure Equalization ◽  
Middle Ear Pressure ◽  
Membrane Perforation ◽  
Tube Function ◽  
Mucosal Changes

On 100 pathological ears with tympanic membrane perforation, eustachian tube function was measured by using sonotubometry and the negative pressure equalization test in an attempt to compare these two methods. The pressure equalization test did not appear to be a reliable tool for preoperative clinical determination of tube function because sonotubometry showed tubal opening in 85 % (myringoplasty group) and in 49 % (radical surgery group) of pathological ears, which were not able to equalize negative middle ear pressure at all during swallowing. The negative pressure equalization test is considered to be unphysiological and may produce a locking phenomenon of the tube. Even a small negative pressure can act like a valve, producing an obstruction that muscle activity of the tube is no longer able to overcome particularly when mucosal changes are present in the tubal orifice. Sonotubometry is a physiological test and as such gives a reliable picture of the opening of the tube during swallowing. Data on tympanic aeration postoperatively will be reported later.

Eustachian Tube Function and Retraction of the Tympanic Membrane

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 65-66 ◽  
Author(s):  
Jörgen Holmquist ◽  
Ulf Renvall ◽  
Pål Svendsen
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Air Pressure ◽  
Eustachian Tube Function ◽  
Present Material ◽  
Pressure Equalization ◽  
Air Volume ◽  
Middle Ear Cholesteatoma ◽  
Tube Function

The medial displacement of the tympanic membrane or the retracted tympanic membrane is a common clinical finding. Also, retractions are looked upon as the precursor of middle ear cholesteatoma. In current otologic literature there seems to be some dispute whether the retractions of the tympanic membrane are caused by negative intratympanic air pressure or by shrinkage of middle ear adhesions pulling the tympanic membrane or part of it medially. In this study only ears with posterior/superior retractions of the tympanic membrane were investigated. Tympanometry revealed that only 33% of the ears did have middle ear pressure within ± 100 mm H2O. After insertion of a polyethylene tube through the tympanic membrane, the eustachian tube function was tested using the air pressure equalization technique. None of the ears could change the negative air pressure upon swallowing. Planometric measurements on the x-ray of the mastoid air cell system of the present material deviate from those of a normal material, indicating a significantly smaller air volume in the present material. It may be concluded that dysfunction of the eustachian tube and a small air volume of the mastoid are characteristic features of an ear with posterior/superior retraction of the tympanic membrane.

scholarly journals Eustachian Tube Function in 6-Year-Old Children with and without a History of Middle Ear Disease

2015 ◽  
Vol 154 (3) ◽  
pp. 502-507 ◽  
Author(s):  
Ellen M. Mandel ◽  
Margaretha L. Casselbrant ◽  
Beverly C. Richert ◽  
Miriam S. Teixeira ◽  
J. Douglas Swarts ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Function ◽  
Tube Function ◽  
History Of ◽  
Middle Ear Disease

scholarly journals Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers

2017 ◽  
Vol 47 (4) ◽  
pp. 223-227
Author(s):  
Stefanie Jansen ◽  
◽  
Manuela Boor ◽  
Moritz F Meyer ◽  
Eberhard D Pracht ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Peak Pressure ◽  
Eustachian Tube Function ◽  
Pressure Equalization ◽  
Negative Shift ◽  
Scuba Divers ◽  
Tube Function ◽  
Eustachian Tube Function Test ◽  
Recreational Scuba

Introduction: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). Methods: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. Results: Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). Conclusion: Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.

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