Eustachian Tube Function Tests Research Articles

Interpretation of the nine-step test for Eustachian tube function should consider mastoid cavity volume.

The modified nine-step test is a classical method for evaluating Eustachian tube function. However, clinical interpretation of the increased maximal difference in middle ear pressure (mdMEP) in the modified nine-step test is unknown. We hypothesised that the different reservoir effects of the mastoid cavity can bias the results of the modified nine-step test. A total of 108 consecutive participants (216 ears) were retrospectively screened. Of these, 55 participants (82 ears) who met the inclusion/exclusion criteria were enrolled. The volumetric results of the mastoid cavity, parameters of the modified nine-step test (mdMEP, middle ear pressure, tympanic membrane compliance), and demographic data were analysed. A significant negative correlation was found between mdMEP and mastoid cavity volume (R = .467, p < .001). Ears with mdMEP >70 daPa showed poor pneumatization in the mastoid cavity, with volumes less than 3000 mm3 (10th percentile of all ears analysed). Ears with mastoid cavity volumes lower than the 25th percentile showed a significantly higher mdMEP (p < .001). Patients with mastoid cavity volumes higher than the 75th percentile were significantly younger (p < .001). Multivariate regression analysis for mdMEP showed a good fit (R = .854) using factors including middle ear pressure, admittance and, most importantly, the reciprocal of mastoid volume (Beta = 0.752, p < .001). The mdMEP, the main parameter of the modified nine-step test, was negatively correlated with the mastoid cavity volume. Therefore, the results of the modified nine-step test should be interpreted with consideration of mastoid cavity volume.

Combined balloon Eustachian tuboplasty/endoscopic sinus surgery for patients with chronic rhinosinusitis and Eustachian tube dysfunction.

To elucidate the role of balloon Eustachian tuboplasty (BET) in the management of chronic rhinosinusitis with obstructive Eustachian tube dysfunction (ETD), we evaluated the results of endoscopic sinus surgery (ESS) with and without BET in patients with chronic rhinosinusitis with obstructive ETD. This randomized controlled trial conducted in a single-institution tertiary care center setting included 50 patients diagnosed with primary chronic rhinosinusitis and obstructive ETD between July 2018 and June 2022. Twenty-five patients were prospectively enrolled for combined ESS/BET. The control group (25 patients) underwent ESS alone. Outcome measurements of the Sinonasal Outcome Test 22,modified Lund-Kennedy score, Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and serial Eustachian tube function test results were analyzed 3 months postoperatively. The improvement (12.60±6.50) in the ETDQ-7 score in the BET group was significantly higher than that in the control group (6.60±5.58). The ratio of improvement in the ETDQ-7 score was also significantly higher in the BET than in the control group (92%vs. 68%, p=0.034). Logistic regression analysis showed that performing BET (odds ratio [OR]: 5.41, 95% confidence interval [CI]: 1.02-28.79, p=0.048) and a low post-modified Lund-Kennedy score (OR: 0.15, 95% CI: 0.04-0.54, p=0.004) were significantly associated with ETDQ-7 score improvement. Combined BET/ESS could decrease otologic symptoms and improve Eustachian tube function. BET may be an appropriate adjunctive procedure for treating chronic rhinosinusitis with obstructive ETD.

Do Flights Affect Hearing in Hot Air Balloon Pilots?

This study aimed to reveal occupational effects on the hearing of hot air balloon (HAB) pilots and examine the relationship between the duration of experience and these effects. This study included 31 male HAB pilots and a control group of 32 male participants. Tympanometry, eustachian tube function (ETF) test, pure-tone audiometry, and transient evoked otoacoustic emission (TEOAE) tests were performed. Pure-tone audiometry results were significantly worse at 125, 500, and 6000 Hz in the right ear and 125, 500, 4000, and 6000 Hz in the left ear in the HAB group than the control group. Although tympanometry evaluation parameters did not differ between the HAB and control groups, ETF test was significantly worse in the HAB group than the controls bilaterally. TEOAE results were significantly worse at 1000, 2000, and 4000 Hz in the right ear and 4000 Hz in the left ear in the HAB group than the controls. There was a significant positive correlation for 125, 4000, 6000, and 8000 Hz between the duration of experience and right ear hearing thresholds. For the left ear, the duration of experience showed a significant positive correlation at 3000, 4000, 6000, and 8000 Hz. When the relationship between the duration of experience and TEOAE results was evaluated, a significant negative correlation was found at 4000 Hz in the left ear. In HAB pilots, in whom eustachian tube dysfunction is quite common, noise and high altitude affected hearing, especially low and high frequencies, and the duration of experience was found to be associated with hearing thresholds.

Results of Eustachian tube balloon dilation measured using the nine-step test

Suggested several decades ago, the nine-step test is an intuitive test of Eustachian tube function. However, studies employing the nine-step test to assess the results of Eustachian tube balloon dilation (EBD) are limited. We aimed to objectively evaluate the efficacy of EBD in opening failure patients with decreased maximal peak pressure difference (MPD) using the nine-step test. Patients who had MPD values ≤ 13 daPa in the nine-step test were enrolled. The patients were categorized into two groups according to treatment decisions after discussion with a clinician: an EBD group (N = 26) and a medication group (N = 30). One month after treatment, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ7) and the nine-step test were administered to all participants and subgroups of symptomatic participants (ETDQ7 > 15). MPD improved (increased) in both the EBD group and the medication group. ETDQ7 values improved (decreased) in the EBD group, but not in the medication group. In subgroup analysis, MPD and ETDQ7 values improved only in the symptomatic EBD group. According to the nine-step test, EBD can normalize 53.8% of decreased MPD. Posttreatment MPD and ETDQ7 scores were significantly better in the EBD group than in the medication group. However, EBD in patients with abnormal nine-step test results seemed less efficacious when the treatment results of the medication group were considered.

Efficacy of Eustachian Tube Function Tests in Predicting Myringoplasty Success Rate

Abstract Background Tympanoplasty is a commonly performed surgical procedure to close perforations of the tympanic membrane. The results of tympanic membrane based on multiple factors as the eustachian tube dysfunction. Aim of the Work to assess the efficacy of the eustachian tube function test in predicting myringoplasty success rate and compare the efficacy of different tests in prediction of myringoplasty outcome. Material and Methods An electronic search via PubMed, Cochrane library, google scholar and web of science (WOS) until janurary2021.We included articles published in English language and conducts adult cases only. We excluded studies based on expert opinion and laboratory studies. Outcomes of interest were success rate of tympanoplasty according to eustachian tube function test and the efficacy of the different tests of eustachian tube function. Analysis was conducted using Comprehensive Meta Analysis© version 3 (Biostat© Englewood, NJ) and the jamovi project (2021); jamovi (Version 1.6.23.0) [Computer Software] for the efficacy of the eustachian tube function tests in predicting tympanoplasty success rate and using Review Manager (RevMan) [Computer program]. Version 5.4. The Cochrane Collaboration, 2020, and MetaDTA: Diagnostic Test Accuracy Meta-Analysis v2.01, 2021 for detecting and comparing the accuracy of different eustachian tube function tests. Results Regarding tympanoplasty success rate meta-analysis of the revelent 14 studies shows that preoperative normal Eustachian tube function is associated with significantly higher probability of successful graft taking (Log odds ratio = 1.78, 95% CI = 1.10 to 2.46).Regarding to the different accuracy of eustachian tube function test meta-analysis of the revelent 14 studies shows that accuracy of the tests are ranked as follows: methylene blue (most accurate), saccharine, impedance audiometry, tubomanometry and sonotubometry (least accurate). Further studies are needed to validate our findings. Conclusions Our pooled estimate suggest a good benefits of preoperative eustachian tube function test and tympanoplasty success rate. According to efficacy of different test of tympanoplasty our pooled estimate that methylene blue test is the most accurate test while the sonotubometry test is the least accurate test.However, our evidence have several limitations and there is controversy among these studies. We suggest further studies are needed to validate our findings to detect the most accurate test of eustachian tube function.

Balloon Dilation Eustachian Tuboplasty for Dilatory Dysfunction With and Without Effusion: A Comprehensive Outcome Analysis.

This study aimed (1) to demonstrate the efficacy of balloon dilation Eustachian tuboplasty (BDET) for dilatory Eustachian tube dysfunction (ETD) and (2) to determine whether adjunctive ventilation tube insertion (VTI) is superior to myringotomy in relieving symptoms for patients with ETD and concurrent middle ear effusion (MEE) treated with BDET. A retrospective cohort study. Tertiary care academic center. Patients with dilatory ETD undergoing BDET with a≥6-month follow-up period were enrolled and evaluated mainly using Eustachian tube function (ETF) tests and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7). Participants with concurrent MEE were further classified into 2 subgroups, BDET with VTI and BDET with myringotomy. An intergroup comparison and comprehensive outcome evaluation were performed. In total, 35 patients with 50 symptomatic ears were enrolled. According to ETF test results, the normalized ETF rate was 94% on the last visit. The mean ETDQ-7 scores decreased significantly from 3.7 ± 1.4 to 2.0 ± 0.9 after interventions, with the most improvement in symptoms occurring for "ear fullness" and "muffled hearing." For the final visit, strong correlations among ETF tests, tympanometry, and Valsalva results were noted. The aforementioned assessment results did not significantly differ between (1) the patients with MEE and patients without MEE and (2) "BDET with VTI" subgroup and "BDET with myringotomy" subgroup. BDET was effective for dilatory ETD, even in cases with concurrent MEE. For patients with ETD and MEE, further research is required to evaluate the benefits of adjunctive myringotomy with or without VTI.

Hearing outcomes in pediatric tympanoplasty and factors affecting surgical outcomes in the current era.

Type-1 tympanoplasty continues to be the treatment of choice for tympanic membrane perforations resulting from chronic suppurative otitis media (CSOM) in children, which is a principal cause of correctable hearing loss in the pediatric population. There is an ongoing debate about the surgical success rate, the factors affecting success as well as the best intervention time for this population group. This study assessed the outcome of Type-1 tympanoplasty in children in terms of 1) graft uptake and 2) hearing improvement as assessed by audiology. The study involved 40 patients aged 6 to ≤14 years suffering from tubotympanic chronic suppurative otitis media. The patients in the study had a central perforation of the pars tensa of the tympanic membrane. Pre-op investigations included Pure tone audiometry, Eustachian tube function test and nasopharyngeal x-ray. Type-1 tympanoplasty was performed on all patients. They were followed up at end of two months, six months, and one year postoperatively to assess surgical success and hearing outcomes. Overall graft uptake and the surgical success rate was 80%. Postoperatively air-bone gap closure up to 5dB was achieved in 62.5% of patients at the end of one year. A normal type A tympanometry curve was achieved in 75% of patients. There was a significant reduction in hearing handicap. The best results were obtained in the 9-10 years age group. Tympanoplasty has a high success rate in children. There is a significant improvement in hearing post-surgery. There is a minimal impact of traditionally believed confounding factors. Considering the positive impact of improved hearing and reduced hearing disability, the authors suggest that surgeons should take young children up for tympanoplasty.

Assessment of the Eustachian tube: a review.

Dysfunction of the Eustachian tube (ET) can lead to negative pressure within the middle ear, which, in turn, causes various pathological changes. Multiple testing methods for ET function have been devised, each with its own advantages and disadvantages. Knowing the characteristics of each ET function test and the unique characteristics of ET dysfunction (ETD) in children are prerequisites for choosing the optimal assessment method. For a comprehensive diagnosis, assessment should also include the localisation of any sites of obstruction. This review aims to summarise the methods of evaluating ET function and locating sites of ET lesions. Articles evaluating ET function, localising lesions in the ET, and ETD in children were collected from the PubMed database. We selected only relevant English publications. ETD in children has different characteristics to those in adults. The appropriate tests for assessing ET function depend on the specific conditions of the individual patient. Valsalva computed tomography can provide information on the soft and bony anatomy of the ET to facilitate identification of lesion sites. An accurate diagnosis should be based on a combined analysis of objective and subjective results, with interpretation made in conjunction with clinical history and physical examination. A comprehensive assessment should include lesion localisation. When assessing ETD in children, it is important to take into account the characteristics of this population.

“Middle Ear Function of Recovered severe acute respiratory syndrome coronavirus-2 (SARS-COV2) Patients”.

Background: Several otolaryngology symptoms are reported with Coronavirus 2019 (COVID-19). Ascending infection from the nasopharynx can affect the conductive part of the hearing pathway. which lead to middle ear effusion. Otitis media may be the first presentation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Objective: To evaluate middle ear function in recovered SARS-COV-2 patients. Also, to compare between the complaint of the patient and the test results. Patient and methods : a case-control study in which the cases and controls groups were age and gender matched, with ages ranging from 18 to 50 years. The middle ear function of both groups was assessed using tympanometry and the eustachian tube function test (ETF). Results: Tympanometry showed a statistically significant difference in the existence of abnormal tympanometry (type C or As) and eustachian tube dysfunction in both ears between patients and controls. According to the comparison, there is a statistically significant difference in both ears between the eustachian tube function and the patient's complaints of ear fullness or a sense of blockage. Conclusions: COVID-19 impairs middle ear function in both sick and asymptomatic individuals.

Eustachian Tube Function Test of Normal Ear in Patients with Unilateral Chronic Otitis Media

Purpose: The aim of this study is to observe the importance of normal ear Eustachian Tube Function Test (ETFT) for unilateral Chronic Otitis Media (COM) and essential date on ETFT through Williams test (Y-266 Hz).Methods: Williams test Y-226 Hz is a test that can evaluate the function of the Eustachian tube only by controlling the pressure, and we retrospectively analyzed 182 otitis media patients who underwent surgery in Pusan National University Hospital. Three results obtained through the Williams test (Y-226 Hz) were classified according to categories and descriptive analysis was performed.Results: In the 182 subjects, 89 did not show changes in static compliance (SC) or had result bias. 1~5 daPa change in 6 (3.3%), 6~10 daPa change 17 (9.3%), 11~15 daPa change 18 (9.9%), 16~20 daPa change 22 (12.1%), 21~25 daPa change 5 (2.7%), 26~30 daPa change 5 (2.7%), 31~40 daPa change 4 (2.2%), 41~50 daPa change 6 (3.3%), 51~100 daPa change changes in 6 (3.3%) and the remaining 4 (2.2%) showed a change greater than 100 daPa. The mean standard SC value of 93 subjects with change was -4.9 daPa, and the mean value measured at positive pressure +400 daPa was -27.4 daPa. Additionally, the mean value measured at negative pressure -400 daPa was +22.9 daPa.Conclusion: Even if the contralateral eardrum appeared normal in the subjects who underwent COM, there were more cases of problems with the Eustachian tube. Normal ear ETFT is necessary for unilateral COM patients, and the Williams test is suitable as a criterion-referenced assessment.

Effect of Gallery Walk Learning Strategy on Clinical Performance of Audiology Students Compared to Traditional Learning Strategy

Background and Aim: Gallery walk is an active learning strategy in form of discussion that enables students to be more active in learning process. This study aimed to evaluate the effect of this strategy on the clinical performance of audiology students.&#x0D; Methods: In this quasi-experimental study, 30 fourth-year undergraduate students in audiology participated. They were assigned into two groups of traditional learning and gallery walk.  The educational content of both groups was similar and was related to the adult care clinical practicum. The assessments included Eustachian tube function test, site-of-lesion tests, and clinical masking. The clinical knowledge, and satisfaction level of students were compared before and after intervention.&#x0D; Results: Before the intervention, the difference in clinical knowledge was not statistically significant between the two study groups (p&gt;0.05). After the intervention, we observed a considerable improvement in knowledge scores in both groups, mostly in the gallery walk group. The mean scores of site-of-lesion tests, and total score of knowledge were also significantly higher in the gallery walk group (p&lt;0.05). The satisfaction level of students was above the average level (mean score=3.9±0.74).&#x0D; Conclusion: The gallery walk strategy has more positive effects on clinical practice of audiology students compared to traditional learning strategy.&#x0D; Keywords: Gallery walk; clinical education; audiology; satisfaction

Correlation of Eustachian tube function with the results of type 1 tympanoplasty: a prospective study

ObjectivesThis study aims to evaluate Eustachian tube (ET) function tests and their impact on outcomes of tympanoplasty in patients with inactive chronic suppurative otitis media.Materials and methodsA prospective study was conducted involving patients diagnosed with chronic suppurative otitis media (CSOM) and having a central dry perforation. Assessment of the ET function was done for all included cases by three tests; pressure swallow equalization test, saccharine test and methylene blue test. The primary outcome is the graft success rate defined as intact graft without any residual perforation at 6 months postoperatively. Secondary outcomes include hearing assessment and possible associated complications.Results64 patients were included in the study with an average age of 36.59 ± 11.96 years. All patients underwent assessment of the ET function by saccharine test, methylene blue test and pressure equalization test (PET) followed by microscopic post-auricular tympanoplasty. Successful tympanoplasty is achieved in 93.75% of cases with residual perforation in four patients. Mean air–bone gap is significantly improved from 23.73 ± 2.80 preoperatively to 10.93 ± 5.46 postoperatively. Results of Methylene blue test has no statistical impact on graft take rate (p value = 0.379), while saccharine test and pressure equalization test results have statistically significant correlation with graft success (p value ≤ 0.001).ConclusionsSaccharine and Pressure equalization tests have a good positive correlation with the graft healing in tympanoplasty, while methylene blue test was found to have no correlation with the success rate.

CORRELATION OF EUSTACHIAN TUBE FUNCTION WITH TYMPANOPLASTY OUTCOME

Background– Eustachian tube play a vital role in the pathogenesis of middle ear cleft disease.Normal eustachian tube function (ETF) is responsible for successful tympanoplasty outcome. Pre operative ETF test should be done. Aim &amp; objective– To evaluate the role of Eustachian tube function in successful graft uptake in tympanoplasty. Method – a prospective study was done on 50 patients, with mucosal type of chronic otitis media (COM). Eustachian tube function (ETF) was assessed with various methods like impedance audiometry (Toynbee's method),methylene blue dye test etc, and correlation of graft uptake with preoperative ETF was done. Result– Out of 50 patients,78% had normal tubal function and 22% had partially impaired tubal function. Tympanoplasty was successful in 92.3% patients with normal ETF and 54.5% patients with partially impaired ETF. Conclusion– There is a strong association between ETF and graft uptake.Thus,proving that eustachian tube plays a major role in the graft uptake.So preoperative ETF should be done.

[Correlation between acoustic immittance and ETS in eustachian tube function test].

Objective:To investigate the correlation between acoustic immittance and eustachian tube score（ETS） in eustachian tube function test. Methods:124 ears eustachian tube function with tympanic tension perforation of 107 patients with chronic suppurative otitis media were measured by acoustic immittance positive pressure balance method and ETS. According to the positive pressure balance test results of acoustic immittance, the ear eustachian tube open pressure between 100 and 200 daPa is assigned 2, the ear with open pressure between 200 and 300 daPa is assigned 3, the ear with open pressure betwween 300 and 400 daPa is assigned 4, the ear open pressure is greater than 400 daPa but eustachian tube open after swallowing is assigned 5, and the ear which eustachian tube open pressure is greater than 400 daPa and cannot open after swallowing is assigned 6. Then compare the results. Results:In the acoustic immittance test, there was no ears whose eustachian tube opening pressure less than 100 daPa, 10 ears（8.1%） open pressure between 100 and 200 daPa, 16 ears（12.9%） open pressure between 200 and 300 daPa, 46 ears（37.1%） open pressure between 300 and 400 daPa, 19 ears（15.3%） whose eustachian tube don't open pressure at 400 daPa but open after swallowing, and the cumulative percentage of the above was 73.4%. There were 33 ears（26.6%） whose eustachian tubes not opening after receiving maximum pressure（400 daPa） and repeated swallowing. The score of acoustic immittance eustachian tube function test was significantly correlated with the scores of ETS, eustachian tube manometry（TMM） and subjective part of ETS（P<0.05）. The result of acoustic immittance was moderately negatively correlated with ETS（r=-0.439） and TMM（r=-0.425）, and weakly negatively correlated with subjective part of ETS（r=-0.249）. The scores of 2-5 points （the affected ears with open eustachian tube in all acoustic impedance test methods） were defined as the normal group, and the scores of 6 point were defined as the abnormal group. The results of acoustic immittance between the normal group and the abnormal group showed that there were significant differences with the subjective scores of ETS, TMM and ETS. The consistency compared the results of acoustic immittance eustachian tube test with the results of ETS was poor（kappa value was negative）, and the difference was statistically significant. Conclusion:The open pressure of acoustic immittance positive pressure balance method is a good predictor of the subjective scores of ETS, TMM and ETS. The smaller the open pressure is, the better the subjective scores of ETS, TMM and ETS may be. This two methods results are inconsistent and cannot be replaced. More consideration should be given to the middle ear. The open pressure, equilibrium pressure and the difference between them need to be paid attention to at the same time.

Association Between Eustachian Tube Dysfunction Questionnaire-7 Scores and Eustachian Tube Function Test Results in Symptomatic Patients With a Normal Drum.

Background and ObjectivesWe investigated the clinical validity of and correlation between the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores and the eustachian tube function test (ETFT) results in patients with a normal drum. Subjects and MethodsThe study included 49 patients (93 ears) with unilateral or bilateral ear fullness over >3 months. All patients were administered the ETDQ-7 survey and underwent the ETFT on the same day. The receiver operating characteristic (ROC) curve and the association between the results were statistically analyzed. ResultsETDQ-7 scores were not significantly correlated with the ETFT results or with middle ear pressure. ETDQ-7 scores in patients with eustachian tube dysfunction (ETD) were significantly higher than those in patients with normal ETFT results (p=0.039) when ETD was defined as a pressure change <10 daPa on the ETFT. The area under the ROC curve was 0.631, with a sensitivity of 37.0% and specificity of 89.4%. ConclusionsThe ETDQ-7 has limited clinical significance in patients with ETD but a normal drum. Therefore, concomitant objective tests should be performed to diagnose patients with ETD.

Eustachian Tube Function Test

Eustachian tube dysfunction (ETD) is a common condition in clinical otolaryngology practice. The eustachian tube (ET) is the only pathway connecting the middle ear cavity and the nasopharynx, and has a ventilation function to equalize the pressure of the middle ear and the atmosphere, a discharge function of middle ear secretions into the nasopharynx, and a defense function to prevent reflux from the nasopharynx. The most important function of the ET is to maintain a consistent middle ear air pressure for efficient sound transmission. Various methods have been used to measure the physiological function of ET. Traditional methods include the Valsalva, Toynbee, and Politzer test. Physiological methods include the 9-step Bluestone inflation-deflation test and sonotubometry. Evaluation of ETD using questionnaires is also being conducted, and currently, imaging tests are also conducted to evaluate the structure of ET. However, no standard protocols have been established until now. In this article, the types, methods, and advantages and disadvantages of the currently available ET function tests are introduced.

Evaluation of Hearing Status and Eustachian Tube Function in Oral Submucous Fibrosis: A Cross Sectional Study

Introduction Oral Submucous Fibrosis (OSMF) in severe cases involves palatal and paratubal muscles of Eustachian tube leading to Eustachian tube dysfunction and hearing disabilities. This study aims to evaluate to evaluate hearing status and Eustachian tube function in patients of Oral Submucous Fibrosis and to correlate them with various groups of the disease. Materials and Methods A Cross Sectional study was carried out in a Tertiary Care Hospital on diagnosed patients of OSMF. Patients with hearing loss due to other middle ear pathologies or previous ear surgeries were excluded. Patients were classified into various Groups depending on the severityof the disease. They were subjected to Pure Tone Audiometry and Impedance Audiometry. Results obtained were statistically analysed. Results A total of 121 patients (242 ears) were included in the study. On Pure Tone Audiometry, minimal hearing loss was found in 20(8.26%) ears while mild and moderate hearing loss was seen in 26(10.74%) and 28(11.58%) ears respectively. On tympanometry, Type B and Type C tympanograms(abnormal) were seen in 36(14.88) and 26(10.74%) ears, respectively. On Eustachian Tube Function Test, out of 242 ears, 67 ears (27.68%) showed Eustachian tube dysfunction. On using Pearson’s chi square test, significant association was found between degree of hearing loss, type of tympanograms and eustachian tube function with various groups of OSMF (p value &lt; 0.05). Conclusion OSMF may affect hearing efficiency and Eustachian tube function as the disease progresses.

ASSESSMENT OF EUSTACHIAN TUBE FUNCTION IN MIDDLE EAR DISEASES

Objective - Purposes of the current study evaluate the function of eustachian tube and compare the outcome of surgery with normal and abnormal eustachian tube functions. Research Design- The present study was using the purposive observational clinical research design. Method-This prospective clinical study was conducted at the department of otorhinolaryngology- Head and Neck surgery, command hospital (eastern command), Kolkata, for a period of eighteen months from Jan 2013 to Jun 2014. The study group comprised of 52 patients who were diagnosed to have Chronic Otitis Media (mucosal disease). The details of history with special emphasis on ear discharge, duration, character and period of dryness were noted. Statistical Analyses- Purpose of the current study descriptive analyses was done with the help of SPSS. Result- The present study shown the age group of 41-60 years (40.38%), mean of age is 39.35 years and standard deviation 17.61 was higher than other age group. Male patients were 28 (53.84%) higher than female patients 24 (46.16%). Methylene blue dye test, otologic instillation test and toynbee's test, were performed, the toynbee's test was statistical signicant in other test. Conclusion- Eustachian tube function tests (Toynbee test) correlated well with severity of disease. The outcome of the middle ear surgery would be a success in normal eustachian tube function, while in dysfunction the outcome need necessarily not be a failure. Tympanometry is a safe easy and effective method to assess the tube function. Gross dysfunction of eustachian tube function predicts poor result.

Eustachian Tube Functions in Concurrent Chemoradiotherapy for Head and Neck Cancer Patients.

Ototoxicity is a dose-limiting adverse event for concurrent chemoradiotherapy (CCRT) with high-dose cisplatin for locally advanced head and neck squamous cell carcinoma (HNSCC). Both irradiation to the Eustachian tube (ET) and weight loss are risk factors for patulous ET. The aim of this prospective, observational study was to elucidate the incidences of patulous ET conditions before and after CCRT in HNSCC patients by means of ET function tests. This prospective, observational study was conducted in 27 HNSCC patients who received CCRT with high-dose cisplatin, and ET function tests (sonotubometry and tubo-tympano-aerodynamic graphy) were performed before and 3months after CCRT. Factors potentially affecting the incidence of patulous ET conditions after CCRT were evaluated. Of the 54 ears from 27 patients investigated, patulous ET conditions were observed in 12 ears (22.2%) from 9 patients (33.3%) before CCRT and 15 ears (27.8%) from 11 patients (40.7%) at 3months after CCRT. Only patulous ET conditions before CCRT in each ear were significantly associated with patulous ET conditions after CCRT (p = 0.010). This is the first report to describe the incidences of patulous ET conditions before and after CCRT in HNSCC patients. HNSCC patients are potentially at higher risk of patulous ET.

Effect of Epidermal Growth Factor with Silastic Scaffold on Tympanic Membrane Perforations of Chronic Otitis Media

Abstract Aims The burden of chronic otitis media continues to be high, especially in developing countries. The demand for corrective procedure of surgical myringoplasty, which is considered the gold standard for tympanic membrane perforations, is also growing. Hence, there is a need to innovate simpler alternative office procedures that could save effort, time, waiting period, and expenditure. Materials and Methods This prospective study of 84 patients with mucosal chronic otitis media was undertaken in a tertiary referral hospital. All patients underwent eustachian tube function test, diagnostic nasal endoscopy, and pure tone audiometry. The size of the perforation was assessed endoscopically. All perforations were freshened first with silver nitrate solution. Silastic pieces were placed medial and lateral to the perforation with epidermal growth factor gel in between. Patients were followed up for 3 months. Results The perforations were classified into three groups (healed, partially healed, and nonhealed) based on the treatment response at the end of the first and third follow-up months. Completely healed and partially healed perforations were considered as “success” and were found to be 79% in this study. Significant association was found between healing status and type of anesthesia. However, the disease stage, size of perforation, and the duration of procedure did not affect the healing status. Conclusion Silastic enhanced myringoplasty with epidermal growth factor is a simple, effective, and economical procedure that can become an alternative to surgical myringoplasty for chronic otitis media.