scholarly journals Methods to Improve the Efficacy of Autoinflation Procedures and to Classify Eustachian Tube Patency

2021 ◽  
Vol 4 (1) ◽  
pp. 01-05
Author(s):  
Sven Stangerup
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Negative Pressure ◽  
Valsalva Maneuver ◽  
Positive Pressure ◽  
Balloon Inflation ◽  
Middle Ear Pressure ◽  
Valsalva’S Maneuver

We describe three methods to improve the efficacy of autoinflation procedures. The subjects were examined after flight with otoscopy and tympanometry. If the middle ear pressures after flight were negative, the passengers were asked to perform a Valsalva maneuver after which tympanometry was repeated. If still negative, the passengers were instructed to perform an extended Valsalva maneuver. If middle ear pressure was still negative, the passenger then was instructed to perform autoinflation using a nasal balloon. Among the ears with initial negative middle ear pressure, 14% normalized the middle ear pressure after Valsalva’s maneuver. In the passengers with a remaining negative pressure, the pressure was equalized to zero or positive pressure in 46% following an extended Valsalva maneuvre. In the ears with remaining negative middle ear pressure after both Valsalva and extended Valsalva maneuver, 69% could normalize the middle ear pressure after nasal balloon inflation.

Comparison of Eustachian Tube Function in Children and Adults with Normal Ears

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 20-24 ◽  
Author(s):  
Anita Bylander
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Pressure Chamber ◽  
Positive Pressure ◽  
Eustachian Tube Function ◽  
Jaw Movements ◽  
Middle Ear Pressure ◽  
Significant Difference ◽  
Tube Function ◽  
Closing Pressure

The eustachian tube function was studied in 53 children and 55 adults, all otologically healthy, by means of tympanometry in a pressure chamber. The ability to equilibrate applied overpressures and underpressures in the middle ear by deglutition or jaw movements, ie, muscular opening function was significantly poorer in children than in adults, and also significantly poorer in younger children than in older ones. The pressure opening function of the tube was determined during reduction of the pressure in the chamber, ie, deflation test. The relative positive pressure persisting in the middle ear after the deflation test, ie, closing pressure, was also measured. No significant difference was found between children and adults. The ability to create a negative middle ear pressure by sniffing (positive sniffing test) was correlated with low closing pressures of the tube. Children with negative middle ear pressures had poor muscular opening function rather than positive sniffing tests. Judging from serial tympanometric measurements for up to two months, also performed in ten sniffing positive and ten sniffing negative children, it seems that the results obtained in the pressure chamber tests reflect a “mean tubal function.”

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.

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.

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.

Middle Ear Pressure and Dysfunction of the Labyrinth: Is There a Relationship?

1997 ◽  
Vol 106 (6) ◽  
pp. 478-482 ◽  
Author(s):  
Wolfgang Maier ◽  
Milo Fradis ◽  
Uwe Ross ◽  
Bernhard Richter
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Sudden Hearing Loss ◽  
Cochlear Function ◽  
Pressure Equalization ◽  
Middle Ear Pressure ◽  
Patient Reported ◽  
Tube Dysfunction ◽  
Ventilation Tubes ◽  
Vestibular Neuronitis

Relationships between middle ear pressure and non-infection-related cochleovestibular dysfunction have been suggested by several authors. According to some data, vertiginous attacks can be prevented by the insertion of a ventilation tube in patients suffering from Meniere's syndrome. The aim of our study was to investigate if the incidence of eustachian tube malfunction and pathologic middle ear pressure is frequent, and if routine implantation of ventilation tubes is reasonable in ears with dysfunctions of the labyrinth, including clinical Meniere's syndrome. So, we determined in our pressure chamber all active and passive parameters of eustachian tube function in 40 patients suffering from Meniere's syndrome, sudden sensory hearing impairment (SSHI), or vestibular neuronitis. Our results disclosed no nonrandom incidence of impaired tubal function among our patients compared to healthy control subjects. Pressure equalization was sufficient in most patients suffering from clinical Meniere's syndrome, and only one patient with vestibular neuronitis presented with a patulous tube. Our results show that impairment of vestibular or cochlear function is not regularly accompanied by eustachian tube dysfunction. Furthermore, no patient reported symptoms while pressure variation was performed. We conclude that variation of middle ear pressure does not usually play a role in the genesis of Meniere's syndrome, vestibular neuronitis, or SSHI. Thus, from our data, we cannot recommend routine implantation of tympanic ventilation tubes in patients suffering from Meniere's syndrome, vestibular neuronitis, or sudden hearing loss.

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.

scholarly journals Does Septoplasty Affect Middle Ear Pressure and Eustachian Tube Function?

2014 ◽  
Vol 36 (3) ◽  
pp. 115-118 ◽  
Author(s):  
Mehmet Ilhan Sahin ◽  
Safak Gulec ◽  
Umit Perisan ◽  
Ismail Kulahli
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Function ◽  
Middle Ear Pressure ◽  
Tube Function

Measuring dynamic Eustachian tube function using tympanometry in a pressure chamber: the effect of nasal betahistine application

2019 ◽  
Vol 133 (7) ◽  
pp. 580-587 ◽  
Author(s):  
B K-H G Franz ◽  
R Patuzzi ◽  
C J Wraight ◽  
G Kay ◽  
A Ng ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Animal Studies ◽  
Pressure Chamber ◽  
Chamber Pressure ◽  
Eustachian Tube Function ◽  
Hyperbaric Chamber ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function

AbstractObjectiveTo assess the effect of topical betahistine on Eustachian tube function in subjectively abnormal subjects in a hyperbaric chamber.MethodActive and passive Eustachian tube function was examined using tympanometry in a pressure chamber.ResultsActive Eustachian tube function was tested against the negative middle ear pressure induced by increasing the chamber pressure to +3 kPa. One voluntary swallow decreased middle-ear pressure by a mean of 1.36 kPa. Passive Eustachian tube function was tested by measuring spontaneous Eustachian tube openings as the chamber pressure dropped from +10 kPa to ambient. Four distinct patterns of Eustachian tube behaviour were seen, three of which indicated Eustachian tube dysfunction. Betahistine had no positive effect on Eustachian tube opening, although previous animal studies had suggested a beneficial effect.ConclusionTopical betahistine had no effect on Eustachian tube function. Combining a hyperbaric chamber with tympanometry proved ideal for evaluating Eustachian tube function.

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.

Effect of Nasal Packing on Middle Ear Pressure

2016 ◽  
Vol 1 (2) ◽  
pp. 52-56
Author(s):  
Abhinav Srivastava ◽  
Puneet Shukla
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Hearing Threshold ◽  
Cross Sectional Study ◽  
Nasal Packing ◽  
Cross Sectional ◽  
Nasal Pack ◽  
Middle Ear Pressure ◽  
Tube Function

ABSTRACT Introduction Eustachian tube connects nasopharynx with the tympanic cavity. The normal middle ear has an inherent tendency to lose gas to maintain the middle ear pressure by diffusion into the surrounding tissues and circulation. Materials and methods This cross-sectional study was conducted in 2012 to 2014. A total of 100 ears of 50 consecutive cases undergoing nasal surgery followed by bilateral nasal packing were included in the study and the middle ear pressure and hearing threshold were determined in all the subjects in presurgery, and then after 48 hours of surgery with nasal packing in situ and then at 7 and 30 days of nasal pack removal. Conclusion There is an increase in middle ear pressure transiently for few days while the nasal pack is in situ, which returns to normal in a month after pack removal; but, in chronic nasal obstruction cases, such as nasal polyps, there is persistent negative middle ear pressure, probably due to irreversible changes in the Eustachian tube function. How to cite this article Mohan C, Srivastava A, Shukla P. Effect of Nasal Packing on Middle Ear Pressure. Int J Adv Integ Med Sci 2016;1(2):52-56.

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