Negative Pressure-induced Secretion of Inflammatory Mediators by Cultured Middle Ear Epithelial Cells: Relevance to Eustachian Tube Dysfunction and Otitis Media with Effusion

Gastroesophageal reflux is a common problem in the newborn and preschool periods. Recent research suggests that it may be related to eustachian tube dysfunction and otitis media with effusion. The purpose of this experiment was to investigate the relationship between simulated gastroesophageal reflux and eustachian tube dysfunction. Rat middle ears were repeatedly exposed (transtympanically) to pepsin in hydrochloric acid or to phosphate-buffered saline solution. Their eustachian tube function was evaluated by assessing passive opening and passive closing pressures, and active clearance of positive and negative pressure. The passive pressure function tests showed variable results. The rats exposed to pepsin in hydrochloric acid had an impaired ability to clear positive and negative pressure from the middle ear as compared to the rats exposed only to phosphate-buffered saline solution. The results demonstrate that multiple middle ear exposures to pepsin in hydrochloric acid leads to eustachian tube dysfunction in rats.

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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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Nasal and Otologic Effects of Experimental Influenza a Virus Infection

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949410300111 ◽

1994 ◽

Vol 103 (1) ◽

pp. 59-69 ◽

Cited By ~ 76

Author(s):

William J. Doyle ◽

Craig A. Buchman ◽

David P. Skoner ◽

James T. Seroky ◽

Frederick Hayden ◽

...

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Influenza A ◽

Serum Antibody ◽

Eustachian Tube Dysfunction ◽

Upper Respiratory Tract ◽

Tube Dysfunction ◽

Antibody Titers ◽

Experimental Influenza

Past studies showed that experimental rhinovirus colds in adults resulted in eustachian tube dysfunction and abnormal middle ear pressures. In the present study, the symptoms and pathophysiologic findings accompanying experimental influenza viral infection were documented. A total of 33 healthy adult volunteers were intranasally challenged with an influenza A/Kawasaki/86 (H1N1) virus and cloistered over a 9-day postchallenge period to monitor for evidence of infection, signs and symptoms of illness, and the extent and frequency of pathophysiologic responses of the nose, eustachian tube, and middle ear. Results showed a protective effect of high (≥16) prechallenge specific hemagglutination-inhibition antibody titer on the rate of infection and the magnitude and extent of provoked symptoms and pathophysiologic findings. Infected subjects with low (<16) prechallenge serum antibody titers (n = 21) developed significant respiratory illness. These subjects also had objectively measurable increases in nasal secretion production, and decreased nasal patency and mucociliary clearance rates. More than 80% of the infected subjects developed eustachian tube dysfunction, and approximately 80% had middle ear underpressures of less than −100 mm H2O on study days 4 and 5. Five of 21 infected subjects with low prechallenge antibody titers had otoscopic evidence of otitis media with effusion. These results support a causal role for viral upper respiratory tract infection in the pathogenesis of otitis media, possibly mediated by the early development of eustachian tube dysfunction and abnormal middle ear pressure.

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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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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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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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Biological Mediators of Inflammation in Middle Ear Effusions

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894760850s218 ◽

1976 ◽

Vol 85 (2_suppl) ◽

pp. 90-96 ◽

Cited By ~ 39

Author(s):

Joel M. Bernstein

Keyword(s):

Otitis Media ◽

Eustachian Tube ◽

Middle Ear ◽

Potential Role ◽

Otitis Media With Effusion ◽

Chemotactic Factor ◽

Mediators Of Inflammation ◽

Tube Dysfunction ◽

Middle Ear Cleft

Four biological mediators of inflammation have been found in middle ear effusions from patients with otitis media with effusion. They are chemotactic factor(s), macrophage inhibition factor(s), activated complement and prostaglandins. The potential role of these mediators has been discussed in relation to their potential for maintaining inflammation in the middle ear cleft after Eustachian tube dysfunction.

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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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