scholarly journals Intradermal Testing Doubles Identification of Allergy among 110 Immunotherapy-Responsive Patients with Eustachian Tube Dysfunction

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 763
Author(s):  
David S. Hurst ◽  
Bruce R. Gordon ◽  
Alan B. McDaniel ◽  
Dennis S. Poe

The purpose of this study was to determine whether the sensitivity advantage of intradermal dilutional testing (IDT) is clinically relevant in patients with obstructive Eustachian tube dysfunction (ETD) or otitis media with effusion (OME). This retrospective, private-practice cohort study compared the sensitivity of skin prick tests (SPT) vs. IDT in 110 adults and children with suspected allergy and OME. Primary outcome measure was symptom resolution from allergy immunotherapy (AIT). IDT identified 57% more patients as being allergic, and 8.6 times more reactive allergens than would have been diagnosed using only SPT. Patients diagnosed by IDT had the same degree of symptom improvement from immunotherapy, independent of allergen sensitivity (66% by SPT vs. 63% by IDT; p = 0.69, not different). Low-sensitivity allergy tests, which may fail to identify allergy in over two thirds of children aged 3 to 15 as being atopic, or among 60% of patients with ETD, may explain why many physicians do not consider allergy as a treatable etiology for their patient’s OME/ETD. IDT offers superior sensitivity over SPT for detecting allergens clinically relevant to treating OME/ETD. These data strongly support increased utilization of intradermal testing and invite additional clinical outcome studies.

1993 ◽  
Vol 113 (sup500) ◽  
pp. 66-69 ◽  
Author(s):  
Tadashi Iwano ◽  
Takuya Kinoshita ◽  
Eimoto Hamada ◽  
Tadashi Doi ◽  
Koichi Ushiro ◽  
...  

2021 ◽  
pp. 014556132198945
Author(s):  
Alessandra Manno ◽  
Giannicola Iannella ◽  
Vincenzo Savastano ◽  
Tommaso Vittori ◽  
Serena Bertin ◽  
...  

Introduction: To our knowledge, few papers have addressed preoperative evaluation of the impact of adenoid hypertrophy (AH) on the pathogenesis of eustachian tube dysfunction (ETD) in children with otitis media with effusion (OME). Aim: The aim of this study was 2-fold: first, to evaluate ETD using tubomanometry and Eustachian Tube Score 7 (ETS-7), in a group of children having AH; second, to assess the clinical impact of adenoidectomy on the ETD of these patients. Methods: Fifty patients, aged 4 to 15 years, underwent adenoidectomy based on various parameters: size of the adenoids causing canal obstruction (grades 1-4), the presence of OME, and recurrent episodes of rhinosinusitis. The function of the eustachian tube was evaluated using ETS-7 before and after surgical treatment. The patients were followed up for 6 months. Results: Forty children presented ETD. Of these, 36 had a grade 4 AH. The preoperative mean value for ETS-7 was 6.62. The mean postoperative ETS-7 score showed a value of 9.60 with a statistical difference compared to the preoperative value ( P = .0015). Conclusions: Adenoid hypertrophy has a high impact on the frequency of ETD. In the patients observed in the present study, the ETS-7 score appeared to be a valid tool for assessing ETD both preoperatively and postoperatively. Adenoidectomy seemed to be effective in improving ETD as well as middle ear ventilation.


2018 ◽  
Vol 132 (2) ◽  
pp. 111-116 ◽  
Author(s):  
K Akazawa ◽  
H Doi ◽  
S Ohta ◽  
T Terada ◽  
M Fujiwara ◽  
...  

AbstractObjective:This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion.Methods:The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose–volume histogram parameters.Results:Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes.Conclusion:The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.


2017 ◽  
Vol 131 (7) ◽  
pp. 614-619 ◽  
Author(s):  
T Singh ◽  
V Taneja ◽  
K Kulendra ◽  
M Farr ◽  
J Robinson ◽  
...  

AbstractBackground:Eustachian tube dysfunction is a poorly defined condition associated with various symptoms and it can predispose to middle-ear disease. Balloon dilation Eustachian tuboplasty has been proposed as a treatment for Eustachian tube dysfunction.Objective:To evaluate the subjective and objective outcomes of balloon dilation Eustachian tuboplasty in patients with recurrent, previously treated chronic Eustachian tube dysfunction.Methods:The study was conducted on 11 patients (13 ears) who had undergone previous unsuccessful medical and surgical treatment. Tympanometry was the primary outcome measure. Secondary outcome measures included pure tone audiogram assessment and seven-item Eustachian Tube Dysfunction Questionnaire score.Results:Balloon dilation Eustachian tuboplasty resulted in significant improvements in 11 patients’ subjective but not objective outcome measures.Conclusion:The objective abnormality and subjective symptoms in Eustachian tube dysfunction may represent two distinct pathological processes, which may nevertheless influence and exacerbate each other.


1993 ◽  
Vol 14 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Akihiko Fujita ◽  
Iwao Honjo ◽  
Kyosuke Kurata ◽  
I-Ken Gan ◽  
Haruo Takahashi

2007 ◽  
Vol 137 (2) ◽  
pp. 321-326 ◽  
Author(s):  
Deidra A. Blanks ◽  
Charles S. Ebert ◽  
Rose P. Eapen ◽  
Carlton Zdanski ◽  
Ekambar R. Kandimalla ◽  
...  

BACKGROUND: Otitis media with effusion (OME) is often associated with allergies. Immune modulatory oligonucleotides (IMO) mediate allergic inflammation and may therefore be efficacious in the treatment of airway inflammation. OBJECTIVE: To evaluate the role of an IMO via transtympanic mucosal application in prevention and treatment of ovalbumin-induced OME. DESIGN: Forty brown Norway rats were divided into control and treatment groups. Eustachian tube dysfunction was evaluated by passive opening pressures, passive closing pressures, active clearance of negative pressure, and mucociliary clearance transit time. RESULTS: Rats who underwent IMO treatment required 50% less pressure to open and close the eustachian tube ( P < 0.05) and were able to actively clear 50% more negative pressure than the ovalbumin-control rats ( P < 0.001). The treatment rats' mucociliary clearance time was half that of the control group ( P < 0.001). CONCLUSION: IMO via transtympanic application can prevent and treat allergy-induced eustachian tube dysfunction in rats. IMO may offer substantial promise in the future management of OME.


2021 ◽  
Author(s):  
Nihat Kılıç ◽  
Özgür Yörük ◽  
Songül Cömert Kılıç

ABSTRACT Objectives To determine whether dysfunctional Eustachian tubes of children with resistant otitis media with effusion (OME), ventilation tube placement indication, and maxillary constriction will recover after rapid maxillary expansion (RME). Materials and Methods The RME group consisted of 15 children (mean age: 10.07 years) with maxillary constriction, Eustachian tube dysfunction (ETD), and resistant OME. The control group consisted of 11 healthy children (mean age: 8.34 years) with no orthodontic and/or rhinologic problems. Recovery of Eustachian tube dysfunction was evaluated by Williams' test at three timepoints: before RME/at baseline (T0); after RME (T1); and after an observation period of 10 months (T2). The control group was matched to all these periods, except T1. Results In the control group, functioning Eustachian tubes were observed in all ears at baseline (T0), and tubes showed no worsening and no change during the observation period (T2) (P &gt; .05). In the RME group, functioning Eustachian tubes were observed in eight of 30 ears and ETD was observed in the remaining 22 ears at baseline (T0). The RME group showed significant improvements in tube functions after RME and the observation period (P &lt; .05). Fifteen of 22 dysfunctional ears recovered (68.2%) and started to exhibit normal Eustachian tube function after RME (T1) and the observation period (T2). Conclusions The findings suggest that ears having poorly functioning Eustachian tubes are restored and recovered after RME in most of children with maxillary constriction and resistant OME. Thus, RME should be preferred as a first therapy alternative for children with maxillary constriction and serous otitis media.


2005 ◽  
Vol 119 (1) ◽  
pp. 36-37 ◽  
Author(s):  
J Tahery ◽  
S R Saeed

Ventilation tube insertion plays an important role in the management of otitis media with effusion. In selected cases, repeated grommet insertion due to persistent eustachian tube dysfunction necessitates the need for longer-term ventilation. Insertion of such tubes can however occasionally be more difficult than insertion of standard grommets. One such long-term ventilation tube is the Shah permavent grommet. This paper describes a simple modification of the technique that is less time-consuming and less traumatic.


2021 ◽  
Vol 156 (0) ◽  
pp. 213-216
Author(s):  
Aya Niwa ◽  
Kunihiro Mizuta ◽  
Shiori Endo ◽  
Hiroshi Nakanishi ◽  
Takashi Yamatodani ◽  
...  

2021 ◽  
pp. 019459982110379
Author(s):  
David Keschner ◽  
Rohit Garg ◽  
Randall Loch ◽  
Lauren Joelle Luk

Objective With increased focus on surgical management of the eustachian tube, clarifying management decisions benefits patients and surgeons. In this study, we examine the value of repeating the balloon dilation of the eustachian tube (BDET) procedure in patients who did not improve after the initial BDET. Study Design Level IV retrospective review of 145 BDETs performed on 86 patients between January 1, 2014, and May 1, 2019, identified 10 patients who underwent BDET more than once. Setting Managed care community otolaryngology practice. Methods Demographic and outcome data were collected on both single and repeat BDET cohorts. Results The Eustachian Tube Dysfunction Questionnaire 7 (ETDQ-7) was used as the primary outcome measure when comparing single vs repeat BDET cohorts. Generally, the 2 cohorts were similar in terms of sex and age distribution. Tobacco use and radioallergosorbent test–positive results were greater proportionally in the repeat BDET cohort. Preoperative ETDQ-7 scores were similar in both cohorts. Single BDET patients overall showed significant improvement in ETDQ-7 scores. ETDQ-7 scores for repeat BDET patients who did not improve after the first procedure similarly did not demonstrate improvement after the second procedure. Conclusions Inevitably, some patients will not improve after an initial BDET procedure. The utility of a repeated BDET procedure should be considered in determining how to manage such failures. The results of this limited study suggest that patients who fail to improve meaningfully on ETDQ-7 scores after the initial procedure are unlikely to show substantial improvements after a repeated procedure.


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