Eustachian Tube Pressure Research Articles

Clinical observation of chronic recurrent secretory otitis media in adults treated by balloon dilatation of Eustachian tube combined with myringotomy and catheterization

Objective:To explore the clinical effect of balloon dilatation of the Eustachian tube combined with myringotomy and catheterization in treating chronic recurrent secretory otitis media in adults. Methods:100 cases（135 ears） of chronic recurrent secretory otitis media in our hospital from January 2018 to May 2020 were selected as the research objects, and were divided into two groups according to the random number table method, 50 cases（68 ears） in the control group and 50 cases（67ears） in the observation group. The control group received tympanostomy and catheterization, while the observation group received tympanostomy with catheterization and balloon dilatation of the Eustachian tube. The total effective rates, Eustachian tube dysfunction scores, Eustachian tube pressure R scores, pure tone thresholds, complication rates, scores of life quality and recurrence rates 1 year after operation were compared between the two groups. Results:The total effective rate was higher in the observation group than the control group（P<0.05）. Compared with pre-operation, the score of Eustachian tube dysfunction, the pure tone listening threshold of each frequency were lower and the Eustachian tube pressure R scores were higher in the two groups at 3 months, 6 months and 12 months after operation（P<0.05）; 3 months, 6 months and 12 months after operation, the scores of Eustachian tube dysfunction, the pure tone listening threshold of each frequency in the observation group were lower than those in the control group（P<0.05）, and Eustachian tube pressure R scores were higher than those in the control group（P<0.05）. Compared with the control group, the incidence of complications and recurrence rate 1 year after operation were lower in the observation group（P<0.05）. Compared with before operation, the scores of life quality in the two groups were higher at 3 months, 6 months and 12 months after operation（P<0.05）; 3 months, 6 months and 12 months after operation, the scores of life quality were higher in the observation group than the control group（P<0.05）. Conclusion:Tympanotomy combined with balloon dilatation of Eustachian tube can effectively improve the Eustachian tube function of adult patients with chronic recurrent secretory otitis media, it has impressiveclinical effects. On the one hand,it can be better to promote the recovery of patients' hearing and improve the clinical cure rate of patients; On the other hand, it reduce the occurrence of complications and disease recurrence greatly, so the quality of the patients' life were improved significantly.

Eustachian tube dysfunction in patients with house dust mite-allergic rhinitis

BackgroundOne of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease. The prevalence of allergic rhinitis (AR) in adults ranges from 10 to 30% worldwide. However, research on the status of eustachian tubes in AR patients is still very limited.MethodsThis prospective controlled cross-sectional study recruited 59 volunteers and 59 patients with AR from Sun Yat-sen Memorial Hospital. Visual analogue scale (VAS) scores for AR symptoms and seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores were collected for both groups. Nasal endoscopy, tympanography and eustachian tube pressure measurement (tubomanometry, TMM) were used for objective assessment. All AR patients underwent 1 month of treatment with mometasone furoate nasal spray and oral loratadine. Then, the nasal condition and eustachian tube status were again evaluated.ResultsTMM examination revealed that 22 patients (39 ears, 33.1%) among the AR patients and 5 healthy controls (7 ears, 5.9%) had abnormal eustachian pressure. Twenty-two AR patients (37.3%) and 9 healthy controls had an ETDQ-7 score ≥ 15. With regard to nasal symptoms of AR, the VAS scores of nasal obstruction were correlated with the ETDQ-7 scores, and the correlation coefficient was r = 0.5124 (p < 0.0001). Nasal endoscopic scores were also positively correlated with ETDQ-7 scores, with a correlation coefficient of 0.7328 (p < 0.0001). After 1 month of treatment, VAS scores of nasal symptoms, endoscopic scores and ETDQ-7 scores were significantly decreased in AR patients (p < 0.0001), and TMM examination also suggested that eustachian tube function was significantly improved after treatment (p < 0.0001).ConclusionsAR patients, especially those with severe nasal obstruction, could have ETD. The local conditions of the pharyngeal orifices of the eustachian tubes are closely related to the symptoms of ETD. After treatment with nasal glucocorticoids and oral antihistamines, eustachian tube function can significantly improve as nasal symptoms subside.Trial registration Chinese Clinical Trial Registery (ChiCTR2000029071) Registered 12 January 2020—Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=48328&htm=4

Application of Eustachian tube pressure measurement to observe the function of Eustachian tube after tympanostomy in children with otitis media with effusion

Objective:To evaluate the feasibility of Eustachian tube pressure measurement after tympanic membrane placement and the timing of postoperative tube removal. Method:A total of 108 patients（202 ears） with chronic otitis media with effusion（OME）were enrolled. All patients underwent tympanostomy（T-tube） or with adenoidectomy. Eustachian tube pressure measurement（TMM） was performed preoperatively and postoperatively, and the Eustachian tube score（ETS-5） was recorded before and 6 and 12 months after surgery and statistical analysis was performed. Result:There was a statistically significant difference between the preoperative ETS-5 scores at 6, 12, and 18 months after surgery. There was no significant difference between the 12 months and 18 months after surgery. There was no significant difference in the recurrence rate of OME in patients with tympanic membrane indwelling time of 12 months and 18 months, but the rate of perforation was 18 months. Conclusion:The tympanic ventilation tube helps the recovery of the Eustachian tube function. The TMM examination is simple and non-invasive. It is suitable for the evaluation of the timing of the tympanic ventilation tube. The tympanic membrane is suitable for tube removal after 12 months of indwelling.

Efficacy of balloon Eustachian tuboplasty combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction

To evaluate the efficacy of balloon Eustachian tuboplasty (BET) combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction (CDETD). A retrospective study was performed in 19 patients with CDETD who underwent BET at the Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, from October, 2014 to September, 2016. The ages of these patients ranged from 10 to 67 years. All the patients underwent the preoperative assessment of oto-endoscope, tympanometry, pure tone audiometry, fiber nasopharyngeal endoscopy, Eustachian tube pressure measurement (TMM), CT and MRI. These patients had failed to respond to medicine, multiple tympanic membrane puncture and at least 2 times grommet insertion before our study. BET was performed in 5 patients (5 ears), and BET+grommet insertionwas performed in other 14 patients (23 ears). The changes of Eustachian tube function in these patients was assessed using the Eustachian tube score (ETS) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) preoperatively and 1, 3, 6, 9 and 12 months after surgery, respectively. In addition, subjective symptoms including the difficulty level of valsalva, aural fullness and earache were assessed by visual rating scale (VAS score) preoperatively and at 1, 6, and 12 months after surgery. The mean scores before surgery were compared with that at 1, 3, 6, 9 and 12 months. Postoperative adverse reactions and complications were recorded, such as earache, nosebleeding and so on. Valsalva score and VAS score for aural fullness before surgery were 8.286±0.189 and 8.571±0.221, respectively. Valsalva score and VAS score for aural fullness were 3.714±0.317, 2.393±0.434, respectively, at one month after surgery, which were decreased significantly, as compared with the scores before surgery (P<0.05). VAS score at 6 months and 12 months after surgery were statistically significant compared with those before surgery (P<0.05). ETS score after surgery was significantly higher than that before surgery (P<0.05). ETDQ-7 score after surgery was significantly lower than that before surgery (P<0.05). The subjective satisfaction in these patients was 84.2%. BET is simple and safe, with fewer complications, and effective for the treatment of CDETD combined with grommet insertion.

Eustachian tube pressure equilibration. Temporal analysis of pressure changes based on direct physiological recordings with an intact tympanic membrane

Eustachian tube function is important in pressure regulation of the middle ear. The efficacy or magnitude of pressure equilibration by tube openings should be determined by the gradient between middle ear and ambient pressure, but in theory also the duration of the tube opening may play a role.This study employed direct measurements of middle ear pressure in patients, who after parotidectomy had a catheter inserted into the mastoid with a pressure transducer connected. Thus, monitoring of the middle ear pressure in response to experimentally induced pressure changes could be performed under physiological conditions with an intact tympanic membrane. A set of six experiments was performed in four healthy subjects with different pressure deviations, where the counter-regulation was recorded over 10 min's time frames; a total of 75 events of tube openings were recorded. The transducer had a high accuracy of ±0.1 daPa, and data were sampled at 10 Hz, so that detailed parameters for each tube opening event could be obtained: the pressure change, the pressure gradient, and the duration of the opening were determined.The pressure changes in response to Eustachian tube openings showed significant positive correlation to the pressure gradient and ambient pressure (p < 0.001). However, the duration of the opening time was not related to the pressure gradient (p = 0.16), as well as the pressure change was also not related to the duration of the opening time (p = 0.34). This meant that the magnitude of a pressure equilibration during tube openings was only determined by the pressure gradient and not variations in the duration of the opening time. Additional correlations were investigated including the pressure change rate.In conclusion, under physiological conditions the opening of the Eustachian tube behaves similarly to a reflex mechanism with relative constant duration. Therefore, in order to equilibrate higher pressure gradients, series of Eustachian tube openings are needed, rather than the tube will open during a longer period of time.This article is part of a Special Issue entitled “MEMRO 2012”.

耳鼻咽喉科領域における換気力学

Organs in the upper respiratory tract -the ear, nose, throat and trachea, always contain air and act as a passage of air stream, which is closely related to essential functions of these organs, such as ventilation of the middle ear, sensation of smell, swallowing, phonation and respiration. Therefore, aerodynamic measurements of the upper respiratory tract would provide basic and important informations about both physiological and pathological conditions of these organs.Recently, aerodynamic method has been introduced and clinically employed in the field of otolaryngology. Some of the interesting research works are as follows;1. Aerodynamics of the nosea) Air stream in the nasal cavityObservations of air stream in the nasal cavity during respiration were made using the nose of a cadaver, patients after surgical removal of the upper jaw or a silicon model of the nasal cavity.b) Resistance in the nasal cavity during respiration Simultaneous registration of nasal air flow and differential pressure through the use of X-Y recorder permitted measurement of nasal resistance of each nasal flow rate. It was found nasal resistance increased in rhinitis hypertrophicance and decreased in rhinitis atrophicance.2. Aerodynamic measurement of velopharyngeal closureResistance of the velopharynx during speech was also measured by pressure-flow technique. Based on these results, indication of cleft palate operation was made.3. Aerodynamics of the Eustachian tubePressure change in the external ear canal during Valsalva's maneuver and deglutiton was found to represent air stream in the tube and tympanum. Comparison was made between the results obtained by aerodynamic method and Perlman's method, which has been widely used as a test for tubal dysfunction. It was found that aerodynamic method was more reliable and practical than Perlman's method in objective evaluation of the tubal function.Aerodynamic methods above-mentioned have contributed in solving many difficult problems in the field of otolaryngology. By clinical application of these technique more precise and effective diagnosis and treatment of the deseases in otolaryngology are quite promising.