A study on the relevance of preoperative assessment of Eustachian tube function in myringoplasty

Abstract

IntroductIonWe are at this instance of evolving otological journey focusing special attention towards the middle ear reconstructive procedures. Otologists equitably ascribe that adequate eustachian tubal function is one of the necessary prerequisites for successful myringoplasty and tympanoplasty surgery. [1][2][3] Difficulty stems from disorders of the eustachian tube influencing the pathogenesis and course of middle ear disease and its medical and surgical treatment; hence, the ability to measure its ventilatory function by a method based on underlying morphological and physiological factors becomes of unsurmountable importance. When exploring for ways to improve the long range surgical success rate for tympanoplasties, it intrigued the otologists to search possible methods of predicting the results of reconstructive middle ear surgeries. Holmquist et al, in cases with chronic otitis media, were the first to study the relationship between Eustachian tubal function, size of mastoid air cell system, and healing. [4]The aim of this study is to find the relevance of pre-operative assessment of Eustachian tube function on the results of myringoplasty and to correlate the outcome of surgery with the tubal function gradings. materIals and methodsThe present study included 58 cases of chronic suppurative otitis media (CSOM), inactive stage (tubotympanic type) planned to undergo myringoplasty. All patients selected were those who came to ENT department during the period from August 2004 to November 2005. A detailed history was taken and a thorough ear, nose and throat examination was done.Control group A consisted of 27 cases of dry central perforation, where pre-operative Eustachian tube function aBstract Aim: Pathophysiology of Eustachian tube significantly affects the result of middle ear reconstructive surgery. The aim of this study is to ascertain the relevance of preoperative assessment of tubal function on the results of myringoplasty and to correlate the outcome of surgery with the tubal function gradings. Materials and Methods: A total of 58 cases of dry central perforation of tympanic membrane were divided into two groups. In control group A, pre-operative Eustachian tube function was not checked. In Test group B, pre-operative Eustachian tube function was checked by modified inflation-deflation test using impedance audiometer. Results: Success was assessed at 4 th month postoperatively on the basis of intact drum. The results between both groups were compared using Chi-square test. There was no statistically significant difference (P< 0.05) between the control and the test group. Conclusion: The capability to reduce an applied negative pressure correlates well with the successful result of a tympanic membrane graft. However, failure to equilibrate negative pressure does not discriminate between success and failure of this operative procedure.

Platelet Count Increases in Chronic Otitis Media Patients With Blocked Eustachian Tube

“…Pre-operative tympanometric analysis prior to tympanoplasty are important as eustachian tube provides middle ear aeration, drainage and protection function (1,5). A healthy eustachian tube is a prerequisite for tympanic cavity after middle ear surgery.…”

“…Drainage of middle ear fluids and protection from nasopharyngeal secretions are the other functions and if it does not work properly, this may cause chronic otitis media (1). The success rate of tympanoplasty is affected by tube functionality, being higher when tube function is normal and vice versa (2)(3)(4)(5). Tube function can be evaluated using both static and dynamic tests (5)(6)(7)(8)(9)(10)(11).…”