“EFFECT OF ANTERIOR NASAL PACKING ON MIDDLE EAR FUNCTION AND HEARING: A PROSPECTIVE STUDY”

2020 ◽  
Vol VOLUME 8 (ISSUE 1) ◽  
pp. 9-14
Author(s):  
Sachin Jain
Keyword(s):  
Prospective Study ◽  
Key Words ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Hearing Threshold ◽  
Nasal Packing ◽  
Middle Ear Pressure ◽  
A Prospective Study

Introduction- The Eustachian tube provides an anatomic communication between the middle ear and nasopharynx, and maintains pressure equality across the tympanic membrane. Objective- To see the effect of anterior nasal packing on Otological symptoms, middle ear pressure and hearing Materials and method- This prospective study was carried out during period of September 2018 till August 2019. 100 ears were taken in the study. Middle ear pressure and hearing threshold were evaluated by Tympanometry and Audiometry respectively. Results- Postoperatively two days after anterior nasal packing, there was increase in no. of patient ears with ear fullness, ear ache, tinnitus, hearing threshold and abnormal negative middle ear pressure. After removal of nasal packing up to twelve weeks, improvement in middle ear pressure and hearing threshold was seen. Conclusion- Anterior nasal packing causes decrease in middle ear pressure and increase in hearing threshold. Key words- Eustachian tube, Middle ear pressure, Hearing threshold

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.

scholarly journals All Cartilage No Stitch Type 1 Tympanoplasty – A Prospective Study

2018 ◽  
Vol 26 (3) ◽  
pp. 183-189
Author(s):  
Debdulal Chakraborty ◽  
Chiranjib Das ◽  
Pritam Chatterjee ◽  
Rajesh Hansda
Keyword(s):  
Prospective Study ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Operative Time ◽  
Acoustic Properties ◽  
Graft Material ◽  
Type 1 Tympanoplasty ◽  
Tube Dysfunction ◽  
A Prospective Study

Introduction Although temporalis fascia is the commonly used graft material for tympanoplasty, cartilage has become the material of choice in cases with eustachian tube dysfunction, bilateral disease, total or anterior perforation of tympanic membrane, tympanosclerosis etc. Cartilage slices < 0.5 mm thick are similar to the tympanic membrane in their acoustic properties. The present study is aimed to describe stitch-less type 1 tympanoplasty with sliced tragal cartilage-perichondrium and evaluate anatomical, audiological and cosmetic outcomes. Materials and Methods A prospective study was conducted from March 2014 to August 2016, in ENT department of a Government Medical College and Hospital, West Bengal, India. Primary tympanoplasty cases irrespective of age, size and site of perforation, laterality and eustachian tube function were included in the study. History of previous tympanoplasty or mastoid surgery and cases requiring ossicular reconstruction or mastoidectomy were excluded from the study. Sliced tragal cartilage-perichondrium graft of 0.2 mm thickness was placed in underlay fashion through trans-canal or end-aural route. Results Among 95 cases 38 were male, 57 were female with age range between 7 to 68 years. Average operative time was 30 minutes. Graft take was successful in 97.89% of cases. Average Air Bone Gap 12 months after operation was 13.03dB. Conclusion Sliced cartilage-perichondrium graft gives good balance between sufficient stability and adequate acoustic sensitivity. Moreover, no stitch technique reduces operative time and increases cosmesis.

scholarly journals Effect of Anterior Nasal Packing on Eustachian Tube Function and Middle Ear Pressure

2020 ◽  
Vol 23 (1) ◽  
pp. 27-31
Author(s):  
Md Manjur Rahim ◽  
Ahmmad Taous ◽  
Md Hasan Zafar ◽  
Mozharul Islam ◽  
Khalid Asad ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Neck Surgery ◽  
Nasal Packing ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function ◽  
Medical University ◽  
Head Neck Surgery ◽  
Head Neck

The present study includes evaluation 60 ears of 30 nasal patients admitted to department of Otolaryngology and Head-Neck Surgery at Banghabandhu Sheikh Mujib Medical University. Each patient underwent nasal surgery followed by anterior nasal packing for 48 hours. All patients were investigated by tympanometry prior to surgery, 2nd post operative day before pack removal and on 7th post operative day 5 days after pack removal. This study shows that nasal packing result in Eustachian tube dysfunction and negative middle ear pressure which is reversible in nature. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 27-31

scholarly journals Anterior nasal packing: does it affect middle ear pressure?

2020 ◽  
Vol 6 (7) ◽  
pp. 1316
Author(s):  
K. Pragadeeswaran ◽  
Raj Prakash Yadavkrishnan ◽  
Roopak Visakan Raja
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Tertiary Care ◽  
Nasal Packing ◽  
Care Hospital ◽  
Eustachian Tube Function ◽  
Nasal Surgery ◽  
Middle Ear Pressure ◽  
Septal Surgery ◽  
Tube Function

<p class="abstract"><strong>Background:</strong> Eustachian tube maintains middle ear pressure equal to that of atmosphere. Its function may be deranged due to variety of factors like adenoids, cleft palate, nasogastric tubes, allergy, nasopharyngeal intubations and also by nasal packing following septal surgery. Our aim was to evaluate the effect of anterior nasal packing protocol, on eustachian tube function, followed in our ENT Department for nasal surgeries.</p><p class="abstract"><strong>Methods:</strong> A descriptive study was done on 60 patients undergoing nasal surgery from March to November 2018 was done in the ENT Department of a tertiary care hospital.<strong> </strong>All patients underwent pre-operative otoscopic examination followed by tympanometry. Tympanometry was repeated following nasal surgery with nasal pack in situ and again 24 hours after removal of pack. The results of all these 3 impedance audiometries were tabulated and analysed.  </p><p class="abstract"><strong>Results:</strong> Pre-operatively both ears in all the patients showed type a tympanometry, which implied normal eustachian tube function. Out of 60 patients who underwent nasal surgeries, 40 had abnormal impedance tympanograms immediately after surgery. 26 patients had abnormal impedance tympanogram after pack removal. These patients were treated with nasal decongestants and antibiotics which were routinely prescribed as a post-operative prophylaxis. These patients 1 week after pack removal recorded a normal tympanogram.</p><p class="abstract"><strong>Conclusions:</strong> Changes in middle ear pressure following nasal packing associated with most nasal surgeries were transient but not severe. Hence, we conclude that anterior nasal packing for 24 hours is considered safe, if no other co-morbid factors for altering middle ear pressures are present.</p>

Effect of nasogastric tubes on Eustachian tube function

1990 ◽  
Vol 104 (1) ◽  
pp. 17-19 ◽  
Author(s):  
M. Wake ◽  
D. E. McCullough ◽  
J. D. Binnington
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Nasogastric Tube ◽  
Cell System ◽  
Eustachian Tube Function ◽  
Nasogastric Tubes ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Tube Function

AbstractThe Eustachian tube acts as pressure equalizing tube between the nasopharynx and the middle ear. It also functions as a conduit for removal of secretions from the middle ear and mastoid air cell system into the post nasal space. Eustachian tube function may be assessed objectively using tympanometric measurements. (Brooks, 1968, Lutman, 1987).The post-operative use of nasogastric Ryles tubes is associated with reduced peak middle ear pressure (mmH2O) and reduced peak compliance volumes (ml) as assessed by tympanometry. In addition changes in the appearance of the tympanic membrane may occur with the protracted use of Ryles tubes. This phenomenon is a transient one.Nasogastric tube-induced Eustachian tube dysfunction is a previously unreported entity.

The improvement of middle ear ventilation by laser ablation of the epipharyngeal eustachian tube: a prospective study

2009 ◽  
Vol 24 (5) ◽  
pp. 793-800 ◽  
Author(s):  
B. Sedlmaier ◽  
A. Pomorzev ◽  
A. Haisch ◽  
P. Halleck ◽  
H. Scherer ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Prospective Study ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Middle Ear Ventilation ◽  
A Prospective Study

scholarly journals The Effect of Nitrous Oxide on the Outcomes of Underlay Tympanoplasty: A Prospective Study

2019 ◽  
Vol 98 (10) ◽  
pp. 621-624
Author(s):  
Ufuk Düzenli ◽  
Nazım Bozan ◽  
Mahfuz Turan ◽  
Semra Ağırbaş ◽  
Arzu Esen Tekeli ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Postoperative Pain ◽  
Prospective Study ◽  
Middle Ear ◽  
Anesthetic Agent ◽  
Success Rates ◽  
Middle Ear Pressure ◽  
The Difference ◽  
Graft Success ◽  
A Prospective Study

The main aims of tympanoplasty are eradication of chronic middle ear disease, repair of the tympanic membrane, and restoration of hearing. Nitrous oxide (N2O) is not a commonly preferred anesthetic agent for tympanoplasty because this agent may increase middle ear pressure and displace the graft. In this study, we researched the surgical outcomes of the underlay tympanoplasty performed with N2O anesthesia. Patients who underwent tympanoplasty were included in this prospective study. A type 1 tympanoplasty was performed in all patients using the underlay technique. Patients were randomized to groups that did and did not receive N2O. Preoperative and postoperative hearing thresholds were evaluated, postoperative pain scores were recorded, and the differences between the groups were statistically evaluated. There were 44 patients who received N2O and 44 who did not. The graft success rate was 93.2% in the N2O-receiving group and 84.1% in the nonreceiving group ( P > .05). Hearing levels improved significantly after surgery in each group ( P < .05), but the difference between the groups was not significant ( P > .05). The postoperative pain score was 3.72 ± 1.3 in the N2O-receiving group and 4.45 ± 2.3 in the nonreceiving group ( P > .05). Nitrous oxide is a cheap, safe, and readily available anesthetic agent that provides acceptable success rates in patients undergoing tympanoplasty.

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.

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.

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