Pathophysiological and clinical studies on the effect of tympanoplasty (supplementary studies)-aspects on the eustachian tube (author's transl)

Abstract

In order to study relationship between tubal function before and after tympanoplasty, tubal function tests were performed in 106 patients with chronic otitis media.The morphological changes of the tympanic and nasopharyngeal orifices of the eustachian tube was macroscopically examined in 80 patients out of 106 patients, and relationship between macroscopic finding and tubal function was discussed.A histopathological study was also made in the mucosa of the tympanic orifice.The results obtained in these investigations are briefly summarized as follows:1) the ventilatory function test of the eustachian tube conducted in 106 patients with chronic otitis media, good ventilatory function was seen in 34 patients(32.1%), moderate in 46(43.4%), and poor in 26(24.5%), while in the drainage function test, good drainage function in 38(35.8%), moderate in 40(37.7%), and poor in 28(26.5%), and altogether, good tubal func-tion !n 52(49.0%), moderate in 18(17.0%), and poor in 36(34.0%).2) Postoperative clinical improvement was noted in 24(63.2%) of the patients with good tubal function, and in 6(16.7%) of those with poor tubal function.3) The shape of the nasopharyngeal orifice showed triangular, oval and long elliptical types with almost the same incidence.No particular relationship was noted between the morphology and function of the eustachian tube.The adhesion in the tubal orifice was seen more frequently in the cases with poor tubal function, though the number of these cases was small.Mucosal swelling in the tube was frequently observed in the cases of poor tubal function.4) The mucosal swelling and granulation were frequently observed in the tymprnic orifice with poor tubal function.Histopathology showed changes due to circulatory disturbance and inflammation in most cases.5) The present pathophysiological study on the eustachian tube revealed that the tubal function was poor whenever the swelling change was noted in either tympanic or nasopharyngeal orifice of the patients with chronic otitis media.