Effect of nasal obstruction surgery on eustachian tube function and middle ear ventilation

<p class="abstract"><strong>Background:</strong> The purpose of this study was to assess the effect of surgery for nasal obstruction in improving Eustachian tube function and middle ear ventilation.</p><p class="abstract"><strong>Methods:</strong> This prospective study involved 60 patients with different nasal pathologies causing nasal obstruction along with complaints of ear fullness. In required cases the nasal pathologies were surgically managed. Pre and postoperative impedance audiometric evaluation and nasal endoscopy were done to assess the eustachian tube function, changes the value of middle ear pressure and ear fullness sensation at 1 month and at 3 months after surgery. </p><p class="abstract"><strong>Results:</strong> Preoperatively, 56 (93.3%) patients had sensation of ear fullness, postoperatively at 1 month and at 3 months after nasal surgery only 20 (33.3%) patient and 18 (30%) respectively, has sensation of ear fullness, with significant improvement (p&lt;0.05). Preoperatively, 74 (61.6%) ears were type A tympanogram, 50 ears of them had poor eustachian tube function and 24 ears had good Eustachian tube function. 42 (35%) ears were type C, 4 (3.3%) ear were type B tympanogram, all of them had poor eustachian tube function. The postoperative results of eustachian tube function test and tympanometric value were significantly better than preoperative results (p&lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> We find out that nasal obstruction has a definite relationship with eustachian tube function. Surgery for nasal obstruction has a favourable effect on the middle ear pressure and eustachian tube function. Corrective surgery for nasal obstruction should be considered at least 1 month before undertaking the middle ear surgery to improve middle ear ventilation.</p>

Evaluation of eustachian tube function in chronic suppurative otitis media with reference to its treatment outcome

<p class="abstract"><strong>Background:</strong> The study was undertaken to find out Eustachian tube function in safe type of chronic suppurative otitis media and to study the comparison of graft uptake in normal, partially impaired and grossly impaired Eustachian tube function in safe type of chronic suppurative otitis media.</p><p class="abstract"><strong>Methods:</strong> The present prospective study was conducted in the Department of Otorhinolaryngology and Head and Neck surgery, Sri Maharaja Gulab Singh Hospital, Jammu during the period from November 2016 to October 2017. Patients were diagnosed clinically and also audiometrically by pure tone audiometry and impedance audiometry. Eustachian tube function test- Toynbee test was done in all the patients. </p><p class="abstract"><strong>Results:</strong> Out of 20 patients with normal Eustachian tube function, 19(95%) showed graft uptake. Out of 20 patients with partially impaired Eustachian tube function, 18 (90%) showed graft uptake. Out of 20 patients with grossly impaired Eustachian tube functions 13 (65%) showed graft uptake. Comparison of mean values of pre and post- operative air-bone (AB) gap with respect to normal, partially impaired and grossly impaired Eustachian tube functions is highly significant statistically with (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> As seen in our study, functioning Eustachian tube is an important requirement for optimum outcome of myringoplasty. Testing the functions of Eustachian tube before surgery provides a possibility of predicting the possible outcome of myringoplasty or tymapanoplasty. This is also concluded that a partially functioning Eustachian tube should not be considered to be a contraindication to these surgeries as in many of these cases graft uptake and AB gap closure was good (90%).</p>

Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers

Introduction: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). Methods: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. Results: Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). Conclusion: Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.