Eustachian Tube Function Research Articles

Effect of Modified Furlow Vs Two-Flap Technique on Eustachian Tube Function

Effect of Modified Furlow Vs Two-Flap Technique on Eustachian Tube Function

Concordance Analysis of the Pressure Chamber and Tubomanometer According to Estève for the Determination of Eustachian Tube Opening Pressure.

For the diagnosis of Eustachian tube dysfunction (ETD), clinical procedures such as tympanometry, micro-otoscopy, and maneuvers according to Toynbee and Valsalva only allow an indirect assessment for the moment. With a prevalence of up to 5%, the selection of patients with ETD and its subtypes is clinically relevant. Dynamic methods of Eustachian tube function assessment include a hypo/hyperbaric pressure chamber and Estève's tubomanometer (TMM). One method of assessing ETD is the evaluation of Eustachian tube opening pressure (ETOP). We performed a concordance analysis between pressure chamber and TMM to determine ETOP. For this purpose, we analyzed the measurements of both methods from 28 healthy subjects using Bland-Altman plots, regression according to Passing-Bablok and Lin's concordance correlations coefficient. The maximum tolerated clinical deviation of measured values was set at 10%. A maximum of 53 measurements of ETOP between pressure chamber and TMM were compared. Mean ETOP for TMM was 28.7 hPa, passive opening was 32 hPa, Toynbee maneuver was 28.4 hPa, and Valsalva maneuver was 54.6 hPa. Concordance analysis revealed following results: passive opening versus TMM: Bland-Altman mean difference 3.3 hPa, limits of agreement ±31.8 hPa; Passing-Bablok regression y = 0.67 x + 9.36; Lin's rccc = 0.18. Toynbee versus TMM: Bland-Altman mean difference 0.7 hPa, limits of agreement ±35.8 hPa; Passing-Bablok regression y = 0.47x + 14.03; Lin's rccc = 0.14. Valsalva versus TMM: Bland-Altman mean difference 24.2 hPa, limits of agreement ±117.5 hPa; Passing-Bablok regression y = 0.17x + 25.12; Lin's rccc = 0.18. Estève's tubomanometer and pressure chamber measurements of ETOP are not concordant. The two methods cannot be interchanged without reservation.

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.

Prevalence of Eustachian Tube Dysfunction in Patients with Allergic Rhinitis: An Observational Cross-sectional Study

Abstract Background: Allergic rhinitis (AR) is implicated in the pathogenesis of Eustachian tube dysfunction (ETD). Its sequelae cause burgeoning of several middle ear diseases. Testing of ETD is a diagnostic challenge and requires objective methods of assessment. Materials and Methods: In our prospective observational study, 402 patients with AR were grouped into mild and moderate to severe AR. Nasal endoscopy, tympanometry, and Williams test were used for objective assessment of ETD. The severity and laterality of ETD were assessed and the prevalence of the same was calculated. Statistical Analysis: The graphical tabulation of data was prepared using MS Excel 2010. Unpaired t-test was used to compare the study groups and the association among the groups was extracted with the help of Fisher’s test and Chi-square test. P < 0.05 was considered significant. Results: Mild AR was found in 44.5% of cases, while moderate to severe AR was seen in 55.5% of cases. 38.1% of cases of AR had ETD, out of which significant population (28.6%) had bilateral involvement. The dysfunction was partial or complete in 22.2% and 15.9% patients, respectively. 38.6% of patients had a type C curve on tympanometry in patients with AR and the rest had type A curve. Conclusions: AR patients have a higher propensity to develop bilateral ETD. The patients having moderate to severe AR have more ETD. A tympanometry will only provide information regarding ETD, whether present or absent, whereas ET function tests such as Williams test provide information regarding the functionality of ET and severity of ETD. It is recommended that all newly diagnosed cases of AR should be evaluated for ETD and be followed up regularly.

Assessment of Eustachian Tube Function for Successful Tympanoplasty in Chronic Otitis Media

Introduction: Eustachian tube function (ETF) has been the focus of attention as a prognostic factor for successful tympanoplasty surgery, due to its supposed primary pathogenic role in otitis media. Poor Eustachian tube (ET) function has been blamed to many diseases of middle ear cleft extending from serous otitis media to the squamosal type of chronic otitis media (COM). The objective of this study was to evaluate the effect of ETF on tympanoplasty outcome in the mucosal type of COM patients. Materials and Methods: An observational study was conducted for the patients admitted to the department of ENT and HNS with COM, mucosal type. The study was done from April 2021 to March 2022. ETF was assessed with the Toynbee test and saccharin time test. Results: The mean saccharin clearance time was found to be 17 min. Tympanoplasty was performed on 55 patients; 91.1% of patients showed successful outcome with good graft uptake who had normal ETF; out of 20 patients with partial dysfunction, 12 patients had successful graft uptake, and eight patients showed graft rejection. Conclusion: The automatic Toynbee test can be a practical, objective, and suitable method to assess the ventilatory function of ET. The saccharin test is an easy, cost-effective, and useful diagnostic tool to assess the mucociliary function of the ET. The ventilatory function of ET which is the single most important contributory factor in the pathogenesis of COM should be evaluated with the objective method before tympanoplasty.

Comparison of Eustachian tube function by impedance audiometry and correlation results with tympanoplasty

Comparison of Eustachian tube function by impedance audiometry and correlation results with tympanoplasty

Evaluation of Subjective Eustachian Tube Function and Hearing Perception of Patients with Acute and Chronic Rhinosinusitis

Evaluation of Subjective Eustachian Tube Function and Hearing Perception of Patients with Acute and Chronic Rhinosinusitis

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.

Do Decreased Mastoid Pneumatization, Bilateral Involvement and Eustachian Tube Function Affect the Success of Type 1 Tympanoplasty?

The surgical success rate of tympanoplasty appears to be influenced by a number of variables. Eustachian tube dysfunction has been shown as one of the factors causing failure in tympanoplasty. It is known that bilateral disease and decreased in mastoid pneumatization are associated with Eustachian tube (ET) dysfunction. In this study, the relationship between the success of type 1 tympanoplasty and mastoid pneumatization, bilateral disease and ET function was investigated. A total of 44 patients who were operated for chronic otitis media in our clinic were included. The information of the patients was obtained retrospectively, the direction of the disease (bilateral/unilateral), the status of the graft (intact/perforated), mastoid pneumatization status, and hearing levels (preoperative/postoperative 6th month) were noted. Automatic Williams test was used to tympanometrically evaluate ET functions (ETF) in postoperative period. The relationship between tympanoplasty success and mastoid pneumatization, bilateral disease and ETF was investigated by statistical analysis. The disease aspect was found bilateral in 34.1% (n = 15) of the cases, and unilateral in 65.9% (n = 29) of the cases. Mastoid pneumatization was decreased in 52.2% (n = 23) of the cases, and normal in 45.4% (n = 20). The preoperative air-bone mean difference (gap) of the cases with decreased mastoid pneumatization was found to be statistically significantly higher than the cases with normal mastoid pneumatization (p < 0.05). The closure of the postoperative air-bone gap in patients with unilateral disease direction was found to be statistically significantly higher than in patients with bilateral disease direction (p < 0.05). Also we found significantly worse ET functions both in unilateral and bilateral disease. Preoperative air-bone gap average is higher in ears with decreased mastoid pneumatization, and postoperative air-bone gap closure is higher in unilateral patients. Mastoid ventilation does not make a significant difference in the success of type 1 tympanoplasty. On the other hand, our results support that ET dysfunction can be effective in the occurrence of chronic otitis media (COM).

Different techniques of adenoidectomy and its impact on middle ear pressure: a randomized controlled study

ObjectivesThe aim of this work is to compare between different techniques of adenoidectomy: endoscopic microdebrider-assisted, coblation and conventional adenoidectomy and its effect on middle ear pressure.BackgroundAdenoidectomy, either alone or with tonsillectomy, is considered among the most performed procedures in pediatric otorhinolaryngology. This procedure usually related to the Eustachian tube function and middle ear status. Eustachian tube dysfunction is mainly caused by mechanical obstruction of the tubal orifice, insufficient swallowing and inflammation in the nasopharyngeal mucosa.MethodsThis prospective randomized study was conducted on 90 patients with symptomatic adenoid hypertrophy confirmed by nasopharyngeal X-ray and endoscopic grading preoperatively. Patients were admitted at Otorhinolaryngology department of our institute during the period from January 2022 to January 2023. They were divided into three groups that were operated either by conventional (Group I), endoscopic microdebrider (Group II), or coblation technique (Group III). Each group was assessed through the audiometric parameters plus postoperative bleeding, and VAS results for pain score and postoperative endoscopic grading for adenoid recurrence.ResultsMean age in group A was 9.03 years and in group B was 8.99 years and was 8.99 years in group C with insignificant differences between three groups. There is significant improvement of tympanographic results comparing all groups of the patients at 6 months postoperatively. There is significant relation between the mean VAS comparing preoperative and postoperative results.ConclusionThere are better results in tympanographic data at conventional adenoidectomy versus other techniques. However, there are also better postoperative results after either coblation or endoscopic microdebrider adenoidectomy over the conventional technique.

Impact of palatoplasty techniques on tympanic membrane findings and hearing prognosis in children with cleft palate.

Children with cleft palate (CP) are at high risk of developing otitis media with effusion (OME) due to Eustachian tube (ET) dysfunction. Palatoplasty has been reported to decrease the frequency of middle ear disease and improve ET function, and although various techniques have been developed, there is no consensus on the differences in the impact of different techniques on the middle ear. The purpose of this study was to determine the differential effects of palatoplasty on middle ear function and hearing. We performed a retrospective observational survey of pediatric patients who underwent palatoplasty for CP between June 2010 and October 2018at Tohoku University Hospital. Cases were divided into three groups depending on the palatoplasty procedures performed: the push-back palatoplasty group, the two-flap palatoplasty group, and the Furlow double-opposing Z-plasty group. We examined the differences in clinical characteristics between patients who underwent each procedure. The primary outcome variable was tympanic membrane (TM) findings, and the secondary outcome was hearing test results. Children who underwent the two-flap palatoplasty had a higher tympanostomy tube (TT) insertion rate and a higher total number of TT insertions than those who underwent the Furlow double-opposing Z-plasty or the push-back palatoplasty. The TM retraction rate tended to be lower in the Furlow double-opposing Z-plasty group than in the push-back palatoplasty group or the two-flap palatoplasty group. The hearing test results at the last visit were not significantly different among the three groups. Children who underwent the two-flap palatoplasty had a higher rate of TT insertions, potentially increasing the risk of TM perforation. In contrast, the Furlow double-opposing Z-plasty group had a lower tendency for TM regression, possibly due to improved ET function and reduced incidence of OME. It is important to understand the advantages and disadvantages of each technique before selecting one suitable for the child's cleft and arch width. Additionally, it is important to conduct regular follow-up of TM findings and hearing test results even after palatoplasty.

Eustachian Tube Function Symptoms in Palatal Surgeries for OSA: 3-Month Postoperative Analysis.

To assess the influence of different soft palate surgeries for obstructive sleep apnea (OSA) on eustachian tube function symptoms, considering various potential factors. A prospective, cohort study was conducted on patients who underwent isolated palatal surgeries for OSA at a single academic medical center between 2017 and 2022. Eustachian Tube Dysfunction Questionnaire (ETDQ-7) were assessed at baseline, 1-month, 2-month, and 3-month time points. Patients with retropalatal obstruction underwent tailored surgeries: anterior palatoplasty (AP), expansion sphincter palatoplasty (ESP), or barbed palatoplasty (BP). Baseline OSA severity between baseline and follow-up time points were also examined. In this study, 96 patients with OSA were enrolled and allocated to three surgical groups: AP (n = 30), ESP (n = 32), and BP (n = 34). The mean age was 44.3 ± 10.2 years, with 86% male participants. No significant differences were found between the groups in terms of age, sex, and BMI. A two-way repeated measures ANOVA revealed a significant main effect of time on ETDQ-7 scores (p < 0.001), but no significant main effect of groups (p = 0.109) or interaction between time and groups (p = 0.082). Subgroup analysis showed a significant interaction for the 3-month change in ETDQ-7 scores by OSA severity (p = 0.046). In post hoc analysis, the BP group exhibited a higher mean ETDQ-7 score compared with the AP group at the 3-month follow-up. This study highlights the importance of considering individual patient factors, such as OSA severity and eustachian tube function symptoms, when selecting the most appropriate surgical treatment to optimize outcomes. 4 Laryngoscope, 134:2471-2477, 2024.

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.

Assessment the impact of the torus tubarius correction by power-assisted technique on the equipressor eustachian tube function

Purpose of the research is to evaluate the impact of the torus tubarius correction by microdebrider technique on the eustachian tube function in children without middle ear pathology. Materials and methods. 115 children aged 3 to 12 years participated in the study. All children underwent endoscopic modified microdebridement adenotomy for the first time, which, in the case of tubal hypertrophy (we analyzed the frequency of this phenomenon), was combined with its correction by the microdebridement method. For the next stage of the research, we selected 19 children, who had preoperative intratympanic pressure monitoring results more than -100 daPa and who hadn’t concomitant tonsil hypertrophy (19 children). Control measurement was done on days 1 and 8-10 after the intervention. Depending on the presence/absence of concomitant hypertrophy of the torus tubarius, patients were divided into the main (11 patients) and control (8 patients) groups. The analysis was carried out using the STATISTICA program. Results. 36 patients were diagnosed with torus tubarius hypertrophy. When comparing intratympanic pressure on the 1st day after the intervention in patients of the main and control groups, a significant difference in values was found (-144.37±41.09/-95.00±27.90 daPa). On day 8-10, the intratympanic pressure data in patients of both groups did not differ from each other (-39.15±14.85 daPa in the main and -33.87±19.57 daPa in the control groups) and preoperative values in both groups. Conclusions. Hypertrophy of the torus tubarius is noted in 31.3% of patients with primary adenotomy. The microdebrider technique method of torus tubarius correction is safe in view of the equipressor function of the auditory tube. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the authors.

Association of Pre-operative Eustachian Tube Function with the Graft Uptake After Tympanoplasty.

To assess the eustachian tube function by impedance audiometry (Toynbee's test) in patients of mucosal type of chronic otitis media (inactive stage) and to assess the correlation of eustachian tube function with the results-i.e., success or failure of tympanoplasty in these patients in terms of graft uptake. This was a prospective observational study carried out over one and half years in Department of E.N.T. & Head and Neck Surgery, a tertiary care hospital. The study group comprised of eighty-seven patients who were diagnosed with chronic otitis media mucosal type- inactive stage and were planned for tympanoplasty or tympanoplasty with cortical mastoidectomy. Written informed consent was taken from all patients. The eustachian tube function was assessed preoperatively by impedance audiometry (Toynbee's test). The surgical outcome was tested by looking at the status of the tympanic membrane postoperatively. The surgical outcome in terms of whether a defect was present in the tympanic membrane was compared with the preoperative eustachian tube function. 98.6% of patients with successful surgical outcome had normal eustachian tube function preoperatively while the neo-tympanic membrane was intact in 63.63% and 33.33% of patients with pre-operative partially impaired and grossly impaired eustachian tube function respectively. From our study, we concluded there was a strong association between functioning eustachian tube and graft uptake in tympanoplasty. So eustachian tube plays important role in successful outcome of surgery.

The impact of acute weight loss following bariatric surgery on Eustachian tube function.

Obesity has emerged as a pressing concern in contemporary society, prompting an increase in bariatric surgery (BS) procedures for severe obesity management. Post-bariatric weight loss might cause complications, such as a reduction in the soft tissue surrounding the Eustachian tube, potentially affecting its function. This cohort prospective study, conducted between May and December 2022, aimed to assess the impact of post-bariatric acute weight loss on Eustachian tube function. A total of 54 cases of bariatric surgery and 157 control subjects were included in the study. Data on socio-demographics, weight, and the type of bariatric surgery were collected for the study group. ET function was assessed using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Approximately 55% of the participants fell within the age range of 18-25 years, with the majority (91.4%) having not undergone bariatric surgery. Conversely, participants who underwent BS were significantly more prevalent in the older age groups, specifically those over 50, between 40-50, and 31-40 years (p<0.001). Our sample consisted of 82.5% females and 17.5% males, with BS being significantly more common among male subjects (45.9%) compared to females (21.3%) (p=0.002). The mean total ETDQ-7 in control subjects was significantly higher (11.29±5.49) compared to those who had BS (9.11±4.09). Moreover, when comparing the ETDQ-7 between subjects who had BS and the control group, no statistically significant differences were observed in the total ETDQ-7 score and across all seven items within the ETDQ-7. Based on these findings, bariatric surgery did not have a major effect on ET function.

비중격만곡증과 이관기능의 연관성에 대한 연구

비중격만곡증과 이관기능의 연관성에 대한 연구

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.

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.

The Variability of function of the Eustachian tube in patients with chronic sinusitis.

BackgroundThe Eustachian tube is a complex and inaccessible structure, which is responsible for the ventilation of the middle ear. The aim of the study was the assessment of an impact of chronic sinusitis on the auditory tube function. MethodsThe prospective analysis of 84 surgically treated chronic sinusitis patients was carried out. This study is based on preoperative results of impedance audiometry in correlation with the data from the medical history of chronic sinusitis, symptoms reported by the patients, results of Computered Tomography (CT) and the stage of inflammatory changes according to Lund and Mackay score. ResultsThe significant majority of patients of our study (65) had advanced auditory tube symptoms, while 4 patients suffered from symptoms significantly impacting daily life. In patients with chronic sinusitis the analysis demonstrated that tympanometry type B (12.67) and C (12.4) occured with significantly higher number of points of Lund-Mackay score than type A (9.2). In allergy sufferers type B of tympanometry was more often observed with characteristically bilaterally located inflammatory changes in maxillary and anterior ethmoid sinuses.ConclusionThe profile of chronic sinusitis patient in whom Eustachian Tube Dysfunction is more often observed, is as follows: Lund and Mackay score above 12pathological changes are bilaterally observed in maxillary and frontal ethmoid sinuses decrease of nasal patency nad postnasal dripAllergyoverusing alcohol and cigarettes, at least alcoholWorse result of Lund and Mackay score and the age of patients are 2 factors favoring the dysfunction of the Eustachian Tube.