Eustachian tube function in patients with chronic tubotympanic suppurative otitis media with Eustachian tube dysfunction after tympanoplasty

Abstract

Actuality: In the treatment of chronic tubotympanic suppurative otitis media, one of the main conditions for a successful treatment is a sufficient function of the Eustachian tube (ET). Earlier, the 5th stage of ET function was considered as a contraindication for tympanoplasty. The inflation-deflation test allows accurately assess the degree of dysfunction of the ET and optimize surgical tactics. Aim of the study: To determine the dynamic changes in ET function in patients with chronic tubotympanic suppurative otitis media with dysfunction of ET after tympanoplasty according to the inflationdeflation test. Materials and Methods: We examined 105 patients aged 19 to 56 years, 57 were women and 48 men. At the 1st – 4th grade of ET function according to inflation-deflation test, the result was interpreted as normal – patients underwent tympanoplasty without ventilation tubes (VT). At the 5th stage of ET function, the result was interpreted as abnormal (dysfunction of the ET) – patients underwent tympanoplasty with teflon or silicone VT. Inflation-deflation test was performed in all patients postoperatively after 3, 6, 12 months. With the improvement of ET function (changing grade from 5th to 1-4th, the VT was removed). Results and discussion: Was found that in men, the 5th grade of ET dysfunction is observed less often (37.5%) than in women (52.6%). Improvement of ET function in patients with teflon VT is faster than in patients with silicone VT. At the same time, restoration of the tympanic membrane leads to decrease of the 5th grade of the ET function when comparing between the 3rd and 6th and 12th months, and also between the 6th and 12th months after surgery in both groups of men and women. Conclusions: Tympanoplasty in patients with chronic tubotympanic suppurative otitis media improves the ET function. The inflation deflation test is an objective method and should be the basic examining the ET in the candidate for tympanoplasty.