scholarly journals A paradigm approach toward predicting barotrauma

2019 ◽  
Vol 63 ◽  
pp. 44-48
Author(s):  
V Raghunandan ◽  
SS Mohapatra
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Screening Tool ◽  
Significant Loss ◽  
Causal Factor ◽  
Step Test ◽  
Medical Problems ◽  
And Training ◽  
Nose And Throat

Barotrauma is one of the most common medical problems associated with aviation and has been a causal factor for significant loss of trained aircrew hours. The occurrence of barotrauma has been reported not only in flight but also during simulated exposures to changing pressures as a part of aeromedical evaluation and training. This occurrence is despite the screening of individuals by otoscopy and tympanometry before exposure to barometric changes. In such cases, baro-challenge-induced eustachian tube (ET) dysfunction has been identified as the most probable cause, leading to decreased ability to equalize pressures across the middle ear. This paper describes a paradigm approach to the prediction of baro-challenge-induced ET dysfunction using the nine-step test and ET dysfunction questionnaire. The inclusion of the test as a screening tool before exposure of aircrew to baro-challenge after recovery from their ear, nose, and throat ailments is recommended to prevent occurrence/ reoccurrence of barotrauma.

Therapeutic Effects of an Anticholinergic-Sympathomimetic Combination in Induced Rhinovirus Colds

1993 ◽  
Vol 102 (7) ◽  
pp. 521-527 ◽  
Author(s):  
Donald K. Riker ◽  
J. Owen Hendley ◽  
William J. Doyle ◽  
Timothy P. McBride ◽  
J. Douglas Swarts ◽  
...  
Keyword(s):  
Treatment Group ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Active Treatment ◽  
Nasal Congestion ◽  
Objective Measure ◽  
Active Treatment Group ◽  
Atropine Sulfate ◽  
Step Test ◽  
Therapeutic Effects

This study's objective was to determine if the combination of pseudoephedrine hydrochloride and atropine sulfate attenuates the symptomatic and pathophysiologic response of individuals to experimental rhinovirus infection when given after illness begins. Forty-three susceptible adult volunteers were challenged with rhinovirus type 39 and randomly assigned to 1 of 2 treatment groups. Twenty-one subjects were treated with the active medication (0.3 mg atropine sulfate and 60 mg pseudoephedrine) and 22 subjects were treated with inert capsules identical in appearance. Treatments were administered 4 times daily beginning approximately 24 hours after rhinovirus challenge and extending for 5 days. Before challenge and on each of 5 treatment days, all volunteers were asked to rate symptom severity and were evaluated for secretion production (weighed tissues), nasal patency (active posterior rhinomanometry), nasal clearance (dyed saccharin technique), eustachian tube function (9-step test), and middle ear status (tympanometry). Twenty subjects in each group were infected with rhinovirus type 39 and were included in the efficacy analysis. Between-group comparisons showed no significant differences in total symptom scores, combined nasal symptom score, secretion production, or the frequencies of persons with eustachian tube obstruction or abnormal middle ear pressures. However, an objective measure of nasal congestion was significantly lower in the active treatment group. The nasal mucociliary clearance rate was significantly more impaired in that group. Side effects consistent with anticholinergic activity were reported more frequently in the active treatment group.

Proof of concept study using a modified Politzer inflation device as a rescue modality for treating Eustachian tube dysfunction during hyperbaric oxygen treatment in a multiplace (Class A) chamber

2019 ◽  
pp. 55-61
Author(s):  
Owen J. O’Neill ◽  
Elizabeth Smykowski ◽  
Jo Ann Marker ◽  
Lubiha Perez ◽  
drah Gurash ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Tube Placement ◽  
Treatment Schedule ◽  
Surgical Interventions ◽  
Hyperbaric Treatment ◽  
Middle Ear Pressure ◽  
Tube Dysfunction

Introduction: Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are the most common adverse effects of hyperbaric oxygen (HBO2) treatments. Patients practice equalization maneuvers to prevent ETD and MEB prior to hyperbaric exposure. Some patients are still unable to equalize middle ear pressure. This ETD results in undesirable consequences, including barotrauma, treatment with medications or surgical myringotomy with tube placement and interruption of HBO2. When additional medications and myringotomy are employed, they are associated with additional complications. Methods: A device known as the Ear Popper® has been reported to reduce complications from serous otitis media and reduce the need for surgical interventions (myringotomy). Patients unable to equalize middle ear pressure during initial compression in the hyperbaric chamber were allowed to use the device for rescue. All hyperbaric treatments were compressed using a United States Navy TT9, or a 45-fsw hyperbaric treatment schedule. Patients with persistent ETD and the inability to equalize middle ear pressure were given the Ear Popper upon consideration of terminating their treatment. Results: The Ear Popper allowed all patients to successfully equalize middle ear pressure and complete their treatments. Conclusion: This study substantiates the use of this device to assist in allowing pressurization of the middle ear space in patients otherwise unable to achieve equalization of middle ear pressure during HBO2 treatment in a multiplace chamber.

scholarly journals Salvage Eustachian Tube Cartilage Chip Insertion After Multiple Transnasal Shim Operations in Intractable Patulous Eustachian Tube

2021 ◽  
pp. 014556132199500
Author(s):  
Wei-Ting Lee ◽  
Heng-Jui Hsu
Keyword(s):  
Surgical Technique ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Repeat Surgery ◽  
Ear Infection ◽  
Middle Ear Infection ◽  
Tube Lumen ◽  
Management Method ◽  
Patulous Eustachian Tube

This article presents 2 cases of extremely intractable patulous Eustachian tube following multiple transnasal shim insertion. These cases highlight the disadvantages of repeat transnasal shim operations, including enlargement of the Eustachian tube lumen, frequent dislocation, repeat surgery, recurrent middle ear infection, and shim misswallowing. The patients in these cases were successfully treated with Eustachian tube cartilage chip insertion through a postauricular approach. We describe the surgical technique and advantages of this promising management method.

Causes of failure of combined approach tympanoplasty in the treatment of acquired cholesteatomas of the middle ear and the mastoid

1995 ◽  
Vol 109 (8) ◽  
pp. 710-712 ◽  
Author(s):  
T. R. Kapur
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Squamous Epithelium ◽  
Combined Approach ◽  
Tube Obstruction ◽  
Incomplete Removal ◽  
Tube Dysfunction ◽  
Cause Of Failure ◽  
Causes Of Failure

AbstractForty cases of failed combined approach tympanoplasty were analysed. The commonest cause of failure was adhesions between the facial ridge and the tympanic membrane, causing segmental attico-mastoid malaeration in 51.3 per cent of cases followed-up continually. Other causes were, large dermoids, incomplete removal of squamous epithelium, and eustachian tube obstruction. Eustachian tube dysfunction did not appear to be a major cause of failure.

Serous Otitis Media

1973 ◽  
Vol 82 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Robert W. Veltri ◽  
Philip M. Sprinkle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Secretory Iga ◽  
Secretory Cells ◽  
Sterile Condition ◽  
Local Synthesis ◽  
Serous Otitis Media ◽  
Inflammatory Insult ◽  
Partial Vacuum

The middle ear fluids of seven patients with bilateral, and five patients with unilateral serous otitis media (SOM), were demonstrated to be microbiologically sterile when assessed for the presence of bacteria, mycoplasma, viruses, and fungi. The concentrations of immunoglobulins G, M, A, D, and lysozyme (muramidase) were determined in the serum and middle ear fluids. Lysozyme levels of middle ear aspirates were found to be elevated in SOM patients. The elevated levels of lysozyme in combination with the antibody-containing classes of immunoglobulins may explain the microbiologically sterile condition of the middle ear fluids of SOM patients. Also, the elevated lysozyme concentrations in middle ear fluids may indicate the previous presence of neutrophils and hence a previous inflammatory insult. The increased levels of IgA demonstrated in middle ear fluids may indicate local synthesis of secretory IgA by secretory cells of Eustachian tube and middle ear. The closed Eustachian tube, partial vacuum conditions and absence of a portal of exit for accumulated serous fluids are offered as a possible explanation for SOM.

Immunohistochemical Study of Murine Middle Ear and Eustachian Tube

1989 ◽  
Vol 107 (1-2) ◽  
pp. 97-103 ◽  
Author(s):  
Mitsuaki Takahashi ◽  
Jane Peppard ◽  
Jeffrey P. Harris
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Immunohistochemical Study

Middle Ear Pressure and Dysfunction of the Labyrinth: Is There a Relationship?

1997 ◽  
Vol 106 (6) ◽  
pp. 478-482 ◽  
Author(s):  
Wolfgang Maier ◽  
Milo Fradis ◽  
Uwe Ross ◽  
Bernhard Richter
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Sudden Hearing Loss ◽  
Cochlear Function ◽  
Pressure Equalization ◽  
Middle Ear Pressure ◽  
Patient Reported ◽  
Tube Dysfunction ◽  
Ventilation Tubes ◽  
Vestibular Neuronitis

Relationships between middle ear pressure and non-infection-related cochleovestibular dysfunction have been suggested by several authors. According to some data, vertiginous attacks can be prevented by the insertion of a ventilation tube in patients suffering from Meniere's syndrome. The aim of our study was to investigate if the incidence of eustachian tube malfunction and pathologic middle ear pressure is frequent, and if routine implantation of ventilation tubes is reasonable in ears with dysfunctions of the labyrinth, including clinical Meniere's syndrome. So, we determined in our pressure chamber all active and passive parameters of eustachian tube function in 40 patients suffering from Meniere's syndrome, sudden sensory hearing impairment (SSHI), or vestibular neuronitis. Our results disclosed no nonrandom incidence of impaired tubal function among our patients compared to healthy control subjects. Pressure equalization was sufficient in most patients suffering from clinical Meniere's syndrome, and only one patient with vestibular neuronitis presented with a patulous tube. Our results show that impairment of vestibular or cochlear function is not regularly accompanied by eustachian tube dysfunction. Furthermore, no patient reported symptoms while pressure variation was performed. We conclude that variation of middle ear pressure does not usually play a role in the genesis of Meniere's syndrome, vestibular neuronitis, or SSHI. Thus, from our data, we cannot recommend routine implantation of tympanic ventilation tubes in patients suffering from Meniere's syndrome, vestibular neuronitis, or sudden hearing loss.

The Role of Eustachian Tube Dysfunction in Immune-Mediated Middle Ear Effusion and Inflammation

1985 ◽  
Vol 12 ◽  
pp. S203-S205 ◽  
Author(s):  
Allen F. Ryan ◽  
Jeffrey P. Harris ◽  
Antonino Catanzaro ◽  
Stephen I. Wasserman
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Eustachian Tube Dysfunction ◽  
Middle Ear Effusion ◽  
Immune Mediated ◽  
Tube Dysfunction ◽  
Ear Effusion

scholarly journals Comparative study between throat swab and ear discharge swabs culture and sensitivity findings in pediatric patients with bilateral chronic otitis media

2019 ◽  
Vol 5 (4) ◽  
pp. 932
Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P.
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Throat Swab ◽  
Chronic Otitis Media ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
The Common ◽  
Culture And Sensitivity

<p class="abstract"><strong>Background:</strong> Chronic otitis media is one of the common infections seen in pediatric age group. The most widely recognized route of infection is via the eustachian tube. The inflammation of the pharyngeal end of the eustachian tube may prevent gas exchange, leading to lowering of the middle ear pressure and predisposes to aspiration of nasopharyngeal microbes into the middle ear cleft.</p><p class="abstract"><strong>Methods:</strong> Eighty (80) cases of clinically diagnosed chronic otitis media among pediatric age group of both sexes selected on simple random basis were included in this study. Swabs from both ears and throat were taken and the samples were sent under strict aseptic conditions for culture and sensitivity testing.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 6.1years and the frequency of chronic otitis media was maximum in 1-5 years age group. Male to female ratio was 1.6:1.The most frequent organism isolated was <em>S. Aureus</em> followed by <em>Psuedomonas</em>. The ear swab and throat swab findings showed positive relationship (p&lt;0.05) for the common organisms i.e., <em>S. Aureus</em>, <em>pseudomonas</em> and <em>Streptococcus pyogenes</em> respectively, thus suggesting a common etiological agent. Psuedomonal infection was found to be associated with large perforation in tympanic membrane.</p><p class="abstract"><strong>Conclusions:</strong> The pathology in bilateral ear disease is central i.e., throat. Treatment in these cases is focused on selected drug with optimum dose and calculated regimen of treatment completely, thus reducing the morbidity of loss of physiological function of the ear and the grave complications involved.</p><p> </p>

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