Eustachian tube dysfunction in sleep apnea patients and improvements afforded by continuous positive airway pressure therapy

Cayir, Serkan; Hızlı, Ömer; Kayabaşı, Serkan; Yıldırım, Güven

doi:10.1016/j.bjorl.2020.02.003

Cited by 6 publications

(13 citation statements)

References 14 publications

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“…Screening by title and abstract excluded 380 articles. Detailed full-text review excluded another 4 articles, leaving a total of 7 articles for inclusion in the final analysis (25)(26)(27)(28)(29)(30)(31). Figure 1 provides a summary of the search process.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…The seven included articles were published between 1999 and 2020 and all were prospective studies (25)(26)(27)(28)(29)(30)(31). Direct measurement of MEP by tympanometry was used in all included studies; however, tympanogram results were only reported in two studies (27,29). Four studies (26,(28)(29)(30) examined MEP with gradually increasing CPAP pressures.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…This was the only study that showed how resting MEP could be affected by CPAP therapy by comparing pre-and posttreatment MEP in the same patient group. Two other studies also demonstrated changes in MEP with longterm CPAP use, but did not report pretreatment MEP at rest, which restricted analysis to indirect comparisons between two different patient groups (27,31). Of note, Aksoy et al found that CPAP use produced a more pronounced effect on resting MEP in the right ear compared to the left ear, a finding that is not corroborated by other long-term studies (31).…”

Section: Discussionmentioning

confidence: 99%

“…When applied at a 10 cm H 2 O pressure level, MEP increased by an even greater degree of 81.9 daPa (95% CI [60.2, 103.5], p < 0.00001). Additionally, two separate studies measuring tympanograms showed that CPAP use was associated with conversion from Type B and C to Type A tympanograms; however, the number of studies examining this was not sufficient for meta-analysis (27,29). The results of the meta-analysis are summarized in Figure 4.…”

Section: Changes In Middle Ear Pressurementioning

confidence: 99%

“…Three studies examined the effect of prolonged CPAP use on MEP at rest with measurements taken before and after 6 months of regular CPAP use and produced mixed findings (27,29,31). Aksoy et al evaluated the effect of long-term CPAP use on resting MEP in the left and right ears separately.…”

Section: Long-term Cpap Usementioning

confidence: 99%

See 4 more Smart Citations

The Effect of CPAP on Middle Ear Pressure: A Systematic Review and Meta-analysis

Yuen

Nguyen

et al. 2021

Otology &Amp; Neurotology

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Objective: To assess the effect of short-term and long-term continuous positive airway pressure (CPAP) use on middle ear pressure (MEP) in adult ears. Databases Reviewed: PubMed, Scopus, and Embase were searched through October 2020. Search strategies used a combination of subject headings (e.g., MeSH in PubMed) and keywords for CPAP and middle ear pressure. Methods: English-language articles studying changes in MEP as measured by tympanometry or tympanograms in patients using CPAP were selected for inclusion. Data extraction from included articles included demographics, baseline, and follow-up data. Results: A total of 7 articles representing 664 patients with weighted mean age of 42.5 years (range 34.9-57.8 yrs) were included. Meta-analysis of three qualifying studies demonstrated a positive correlation between higher CPAP pressures and degree of MEP rise during CPAP use compared to baseline with mean difference of 25.1 daPa (95% confidence interval [18.7, 31.4]) at 5 cm H 2 O and 81.9 daPa (95% confidence interval [60.2, 103.5]) at 10 cm H 2 O. Short-term effects of CPAP use were reviewed in four studies that showed a transient rise in MEP. Three separate studies examining the long-term effects of CPAP use showed resting MEP was higher in patients with severe obstructive sleep apnea (OSA), which might be related to progressive eustachian tube dysfunction as a complication of severe OSA. Conclusion: Short-term CPAP use is associated with transient elevations of MEP in adult ears. Long-term CPAP use might produce beneficial MEP changes, especially in patients with OSA and eustachian tube dysfunction.

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