Analysis of the Dysfunctional Eustachian Tube by Video Endoscopy

Poe, Dennis S.; Abou-Halawa, Ashraf Saad; Abdel-Razek, Osama

doi:10.1097/00129492-200109000-00005

Cited by 121 publications

(145 citation statements)

References 7 publications

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“…Active and passive exchange of middle ear gases occurs constantly within the middle ear [20]. Poe, et al [21] reported that normal ETs had four consistent sequential movements: [1] palatal elevation causing passive, then active, rotation of the medial cartilaginous lamina; [2] lateral excursion of the lateral pharyngeal wall; [3] dilation of the lumen, caused primarily by tensor veli palatini muscle movement beginning distally and inferiorly, then opening proximally and superiorly; and [4] opening of the tubal valve at the isthmus caused by dilator tubae muscle contraction [21]. In the present study, sevoflurane is eliminated quickly, and CO 2 diffused into the middle ear cavity is removed quickly due to the function of the ET and also increased microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane vs. TIVA in Terms of Middle Ear Pressure During Laparoscopic Surgery

Güler¹,

Apan²,

Muluk³

et al. 2014

Adv Clin Exp Med

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Objectives. The aim of this study was to investigate the effects of CO 2 insufflation on the pressure of the middle ear cavity (PMEC) during laparoscopic surgery under total intravenous anesthesia (TIVA) with propofol or sevoflurane as an inhalational anesthetic maintenance. Material and Methods. Sixty patients who underwent laparoscopic/or non-laparoscopic surgery under general anesthesia were included in the study. For anesthetic maintenance with inhalation agents, 20 non-laparoscopic surgery patients in Group 1 were applied sevoflurane (2-2.5%). Forty patients who underwent laparoscopic surgery were randomized into two groups. Anesthesia was maintained with sevoflurane (2-2.5%) in twenty patients in Group 2 and the TIVA technique in 20 patients in Group 3. In Group 1, PMEC was measured before anesthesia, 10 and 30 min after endotracheal intubation, 10 min before extubation, and 15, 30, 60 min and 6 hours in the postoperative period. In Group 2 and 3, PMEC was measured before the anesthesia, 10 min after intubation, 10 and 30 min after CO 2 insufflation, just before the CO 2 elimination, 10 min before the extubation, and 15, 30, 60 min and 6 hours after extubation in the postoperative period. Results. PMEC was significantly increased in Group 1 at 10 min after intubation, at 30 min of the operation, before extubation, and at postoperative 15 and 30 min (p < 0.05). In Group 3, differences between PMECs were detected at the 30 th min of insufflation (p = 0.005), and during elimination (p = 0.035) compared to the initial measurement. Generally, the values remained positive in Group 1 and negative in Group 3. There was a significant difference between Group 1 and Group 3 at 10 min after the induction (p = 0.001). There was no statistically significant difference in PMECs between Group 2 and 3 patients undergoing laparoscopic surgery. Conclusions. Our results indicate that, in laparoscopic surgery, TIVA used for the maintenance of anesthesia did not increase the PMEC and the changes caused by sevoflurane were also in the normal range of middle ear pressures. In patients with previous ear surgery, if there is a need of classical surgical procedures in the future, sevoflurane anesthesia should not be the first choice due to its effects on PMEC, which cause it to be increased over 50 daPa, especially at 30 min after intubation. Patient characteristics including previous ear surgery should be considered in selecting the optimum anesthetic agents and technique (Adv Clin Exp Med 2014, 23, 3, 447-454).

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Section: Discussionmentioning

confidence: 99%

Sevoflurane vs. TIVA in Terms of Middle Ear Pressure During Laparoscopic Surgery

Güler¹,

Apan²,

Muluk³

et al. 2014

Adv Clin Exp Med

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“…Edema of ET mucosa could affect tubal motion either from bulk effect, mechanical thickening, and stiffening of the walls or from secretory proteins with increased fluid viscosity. This could be secondary to primary mucosal disease, inflammatory conditions, infection, or allergy and could result in functional closure of the ET lumen [9].…”

Section: Discussionmentioning

confidence: 99%

“…Video endoscopy of Eustachian tube is a promising, efficient and effective newer modality as it gives us, direct real time visualization of the ET and direct assessment of ET functioning [4].…”

Section: Introductionmentioning

confidence: 99%

To Assess the Efficacy of Modality Slow Motion Dynamic Video Endoscopy of Eustachian Tube in Chronic Middle Ear Pathologies

Padhya

Sharma

Mishra

2014

Indian J Otolaryngol Head Neck Surg

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Eustachian tube dysfunction (ETD) has a role in chronic otitis media (COM) is a well known fact and number of modalities have come up for its assessmentslow motion dynamic videoendoscopy (SMDV) being the latest. (i) To find prevalence of ETD in COM and (ii) to check the efficacy of SMDV in detecting dysfunction as compared to gold standard tympaometry (TYM). It's a prospective analytical study with total of 100 patients of chronic otitis media, hence 200 ears were tested for ETD by TYM and SMDV. Prevalence of ETD was noted as 35.5 % in COM whereas the two testing modalities TYM versus SMDV showed agreement in 161 cases out of the 200 ears giving a moderate agreement of statistical significance (Kappa test) suggesting SMDV to be included in standard of protocol when assessing ETD along with TYM.

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“…role of mucosal disease and muscular abnormalities in reducing the mechanical ability of the tube to dilate. As specific disease processes are identified, the possibility of future medical or surgical treatments may become easier and more of a reality [13].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Eustachian Tube Functions in Normal and Diseased Ears with Tympanometry and Videonasopharyngoscopy

Chauhan

2011

Indian J Otolaryngol Head Neck Surg

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Eustachian tube is a bony and fibrocartilagenous tube extending from the antero-inferior part of middle ear cleft to lateral wall of the nasopharynx. Its main functions are ventilation of middle ear to equalize the middle ear pressure with atmospheric pressure and mucociliary clearance. The functioning of eustachian tube has a direct impact on normal middle ear function. As a corollary, dysfunction of eustachian tube inevitably leads to retraction of the tympanic membrane initially and sterile effusion and subsequent conductive deafness later. Secretory otitis media today is the most common cause of conductive deafness in children with an intact ear drum.

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Analysis of the Dysfunctional Eustachian Tube by Video Endoscopy

Cited by 121 publications

References 7 publications

Sevoflurane vs. TIVA in Terms of Middle Ear Pressure During Laparoscopic Surgery

Sevoflurane vs. TIVA in Terms of Middle Ear Pressure During Laparoscopic Surgery

To Assess the Efficacy of Modality Slow Motion Dynamic Video Endoscopy of Eustachian Tube in Chronic Middle Ear Pathologies

A Comparative Study of Eustachian Tube Functions in Normal and Diseased Ears with Tympanometry and Videonasopharyngoscopy

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