Otological Presentation of Obstructive Nasal Lesions: A Study of 50 Cases

Purpose: To analyze and realize the importance of the Eustachian tube dysfunction (ETD) in the pathogenesis of the middle ear infections as to raise the awareness amongst the Otolaryngologists consider the tubal dysfunctions in the management of the otitis media. Materials and methods: 50 patients of aural discharge, aural fullness, aural pain, hearing loss and tinnitus along with nasal obstruction were selected from July 2013 upto December 2013 in the outpatient department (OPD) of Otorhinolaryngology - Head and Neck Surgery dept. of Dhaka Medical College Hospital under a specific prospective study protocol. All patients of aural fullness, hearing loss, aural pain, tinnitus, aural discharge along with nasal obstruction with or without sore throat were included; patients of sensorineural hearing loss, primary external ear pathology, ear malignancy and congenital ear diseaseswere excluded. Results: 58% patients were below 20 years, 50% were children, 64% were male and 36% female. 62% patients got aural fullness, 60% hearing loss 40% mild, 14% moderate, 6% severe conductive and 8% mixed), 26% tinnitus, 32% aural discharge and 30% aural pain and amongst the patients of otitis media with effusion (OME), 100% got hearing loss, 73% aural fullness, 33% tinnitus, 27% aural pain and 13% dizziness. 78% patients got septal deviation, 58% hypertrophied inferior turbinates (HIT), 32% enlarged adenoids (EA), 62% allergic rhinitis, 26% acute upper respiratory tract infection (URTI), 4% nasal polyps and 48% sinusitis/mucosal thickening and amongst the children, 64% got enlarged adenoids, 56% HIT, 76% septal deviation (SD), 24% acute URTI, 4% antrochoanal polyp, 20% adenoid with HIT and 44% adenoid with SD. Regarding findings in the patients of enlarged adenoid, 37.5% patients got eustachian tube dysfunction (ETD) and 62.5% got hearing loss due to OME as well as acute otitis media (AOM), chronic otitis media (COM) and it showed that mild adenoid caused ETD occasionally on URTI but mild adenoid with HIT caused OME. Conclusion: The obstructive nasal lesions are intermingled with otitis media, so this association should be sought out and underlying nasal lesions must be managed if any as a part of treatment of the otitis media. Bangladesh J Otorhinolaryngol 2021; 27(2): 159-169

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The Role of IgE-Mediated Hypersensitivity in Otitis Media with Effusion: A 1987 Update

American Journal of Rhinology ◽

10.2500/105065887781693349 ◽

1987 ◽

Vol 1 (2) ◽

pp. 67-72

Author(s):

Joel M. Bernstein

Keyword(s):

Allergic Rhinitis ◽

Otitis Media ◽

Eustachian Tube ◽

Otitis Media With Effusion ◽

Eustachian Tube Dysfunction ◽

Upper Respiratory Tract ◽

Direct Role ◽

Tube Dysfunction ◽

Ige Mediated

The role of IgE-mediated hypersensitivity in the development of middle ear disease has not been completely resolved. However, on the basis of our investigations and those of other laboratories, we would suggest that approximately two-thirds of patients with chronic recurrent otitis media (OM) are not allergic. The other third may have allergic rhinitis, and this allergic rhinitis may play a direct role in producing eustachian tube dysfunction in recurrent OM. However, viral infections of the upper respiratory tract may also induce IgE-mediated release of mast cell inflammatory mediators and could cause OM on the basis of viral infection alone. The role of allergic rhinitis on eustachian tube dysfunction is now well documented, and finally, the possible role of food allergy and OM must be seriously considered, particularly in the young OM-prone child with chronic recurrent rhinitis and OM.

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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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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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Hubungan derajat obstruksi hidung pada pasien deviasi septum dengan disfungsi tuba Eustachius

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v44i1.79 ◽

2014 ◽

Vol 44 (1) ◽

pp. 19

Author(s):

Sony Yudianto ◽

Luh Made Ratnawati ◽

Eka Putra Setiawan ◽

Sari Wulan Dwi Sutanegara

Keyword(s):

Nasal Obstruction ◽

Eustachian Tube ◽

Septal Deviation ◽

Eustachian Tube Dysfunction ◽

Bivariate Analysis ◽

Case Group ◽

Predisposing Factor ◽

Tube Dysfunction ◽

Septum Nasi ◽

The Right

Latar belakang: Deviasi septum diduga sebagai salah satu predisposisi terjadinya disfungsi tuba Eustachius, terutama di telinga ipsilateral pada sisi hidung yang tersumbat. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara derajat obstruksi hidung pada pasien deviasi septum nasi dengan disfungsi tuba Eustachius. Metode: Diskriptif dan analitik pada penelitian yang kami lakukan di poliklinik THT-KL RSUP Sanglah Denpasar, diikuti 58 orang yang terbagi dalam kelompok disfungsi tuba Eustachius sebanyak 29 responden dan kelompok fungsi tuba Eustachius normal sebesar 29 responden. Hasil: Analisis penelitian didapatkan hubungan yang bermakna yaitu derajat obstruksi hidung kanan pada pasien deviasi septum meningkatkan risiko kejadian 2,85 kali lebih tinggi dengan terjadinya disfungsi tuba Eustachius kanan. Pada sisi kiri juga didapatkan hubungan yang bermakna yaitu derajat obstruksi hidung kiri pada pasien deviasi septum meningkatkan risiko kejadian 2,17 kali lebih tinggi dengan dengan terjadinya disfungsi tuba Eustachius kiri. Pada derajat sumbatan hidung diketahui pada sisi kanan dan pada sisi kiri dengan hasil responden yang mengalami sumbatan hidung derajat berat secara bermakna meningkatkan risiko terjadinya disfungsi tuba Eustachius pada sisi yang sama dengan nilai (p< 0,05). Kesimpulan: Pada penelitian ini didapatkan hubungan yang bermakna antaraderajat obstruksi hidung pada pasien deviasi septum yang meningkatkan risiko terjadinya disfungsi tuba Eustachius pada sisi yang sama.Kata kunci: Disfungsi tuba Eustachius, obstruksi hidung, deviasi septum nasi. ABSTRACTBackground: Septal deviation is suspected as one of the predisposing factor in Eustachian tube dysfunction, especially in the ipsilateral ear on the side of the obstructed nose. Purpose: To find out the relationship between the degree of nasal obstruction in septal deviation patient with Eustachian tube dysfunction. Method: Descriptive analytic studies that we conducted in ENT clinic Sanglah Hospital that divided 58 people into 29 respondents as the Eustachian tube dysfunction group and 29 others as the normal Eustachian tube function group. Result: We found prevalence of right Eustachian tube dysfunction in 21 respondents and the prevalence on the left Eustachian tube dysfunction in 8 respondents, which was on the same side with the obstructed nose in the case group as measured byPNIF. Bivariate analysis found a significant relationship that increased the risk of occurence was 2,85 times higher in septal deviation patients with right obstructed nose with the right Eustachian tube dysfunction. The left side also showed a significant association 2,17 times. Degree of nasal obstruction performed analysis known on the right side and on the left side showed that respondents with severe degrees of nasal obstruction significantly increased the risk of Eustachian tube dysfunction on the ipsilateral side (p<0,05). Conclusion: In this study we have significant association between the degree of nasal obstruction in septal deviation patients which increased the risk of Eustachian tube dysfunction incidence on the ipsilateral side.Keywords: Eustachian tube dysfunction, nasal obstruction, nasal septal deviation.

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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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