Can Uvulopalatopharyngoplasty Be Harmful to Eustachian Tube Function?

Abstract

A study of the Eustachian tube, incorporating nasendoscopy, tympanometry and pressure swallow test was undertaken in patients undergoing uvulopalatopharyngoplasty. Marked negative middle ear pressure indicating impairment of tubal function was found during the first 7 postoperative days. In patients receiving antibiotic treatment the Eustachian tube dysfunction was significantly alleviated. This dysfunction is probably due to a postoperative infective inflammatory process in the tonsillar fossa. Antibiotic treatment is recommended for patients undergoing uvulopalatopharyngoplasty, to improve the postoperative course. Patients with middle ear abnormalities and following middle ear surgery could be high-risk candidates for this operation and should be carefully evaluated.

The immediate effect of adenotonsillectomy on Eustachian tube function in children

“…It was designed to concentrate on the immediate E-tube function after surgery. Most studies have already established that there are immediate and marked MEP reductions that gradually recover [13][14][15][16][17][18][19]. In this study, three weeks after surgery, there were no specific complaints or physical examinations that were suggestive of E-tube dysfunction.…”

“…Finkelstein et al [15] described that uvulopalatopharyngoplasty induced noticeable MEP reduction during the first 7 postoperative days. Marais and Armstrong [17] evaluated the long-term effect of laser-assisted uvulopalatoplasty on middle ear function, and found no significant differences in middle ear volume or pressure three months after surgery.…”

“…There have also been several clinical studies that investigated the relationship between middle ear function and surgeries that address sleep-disordered breathing including uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, Z-palatopharyngoplasty with radiofrequency tongue base ablation, and pillar implants [15][16][17][18][19]. Finkelstein et al [15] described that uvulopalatopharyngoplasty induced noticeable MEP reduction during the first 7 postoperative days.…”

The effect of continuous positive airway pressure on middle ear pressure

“…Surgery for obstructive sleep apnea using Z‐palatopharyngoplasty has a transient effect on lowering middle ear pressures on postoperative day 3, with pressures returning to baseline on subsequent measurements 12. In patients undergoing uvulopalatopharyngoplasty, Finkelstein et al found marked negative middle ear pressure indicating impairment of tubal function during the first 7 postoperative days, which was alleviated with postoperative antibiotics 13…”

Evaluation of middle ear pressure and post-operative adenoid size in adenotonsillectomy: comparison between curettage and endoscopic assisted coblation technique

“…3 Negative pressure changes in the middle ear are observed due to edema in the nasopharynx following tonsillectomy but there aren't many studies to prove the same. 4,5 Tympanometry is indirectly used to determine the middle ear pressure changesboth pre operatively and post operatively. Though endoscopic assisted coblation technique of tonsillectomy and adenoidectomy is superior to curettage there is a paucity of literature to assess the effectiveness in measuring residual adenoid size and evaluate middle ear pressure by tympanometry which was carried out in our study.…”