Eustachian tube closing failure in children with persistent middle ear effusion

Falk, Bernt; Magnuson, Bengt

doi:10.1016/s0165-5876(84)80034-8

Cited by 33 publications

(17 citation statements)

References 12 publications

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“…Factors responsible for the pressure gradient are not well know. However, as signs suggesting this atmospheric pressure gradient, the authors [1985], Bylander et al [1985] and Falk and Magnuson [1984a, b] reported that swallow ing during sleep increases the pressure in the tympanic cavity to about 75 mm H2O. Teramura et al [1986] in our group also reported that the pressure in the tympanic cavity was influenced by changes of head position.…”

Section: Ventilator}' Function Of Eustachian Tube Under Normal Pressumentioning

confidence: 65%

Physiology and Pathophysiology of Air-Filled Ear Space and Eustachian Tube Function

Okubo

Watanabe²

1988

ORL

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The function of the Eustachian tube under atmospheric pressure, on the grounds of our studies, is discussed as follows: (1) Criteria of natural valvular function of the auditory tube under a normal pressure environment. (2) Opening action of the Eustachian tube and mode of swallowing movement in comparison with soft palate movement. (3) High pressure environment and (opening action of) Eustachian tube. (4) Children undergoing tubing and their Eustachian tube function. (5) Ventilatory function of the Eustachian tube under normal pressure conditions. (6) Factors influencing changes in pressure in the tympanic cavity.

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Section: Ventilator}' Function Of Eustachian Tube Under Normal Pressumentioning

confidence: 65%

Physiology and Pathophysiology of Air-Filled Ear Space and Eustachian Tube Function

Okubo

Watanabe²

1988

ORL

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“…Simple, non-invasive tests such as sonotubometry, barotubometry and the 9-step test can determine if the ET opens during specified maneuvers by detecting the presence/absence of signal transmission through the open ET, but provide no information regarding the underlying cause of any observed ET opening failure 12,17,26,27 . Alternatively, more complex, multi-protocol tests that require a non-intact TM can assess the efficiency of ET opening by swallowing and other maneuvers, “rule-out” certain causes of ETD and provide information that may relate to the physical and mechanical properties of the ET that constrain constitutive ETF (see above) 4,8 .…”

Section: Discussionmentioning

confidence: 99%

“…These tests were scored as positive if the change in ME pressure during the maneuver was at least 10% of the maximum nasopharyngeal pressure (peak pressure=PP) recorded during the Valsalva test (Val) or at least 10% of the minimum nasal pressure during the Sniffing test (SNF). Both of these tests are effort-dependent and susceptible to false negative results 4,17 . A negative Valsalva test may evidence a physical obstruction of the ET lumen and a positive Sniffing test was suggested to evidence “ET closing failure” 16 .…”

Section: Methodsmentioning

confidence: 99%

Sensitivity and Specificity of Eustachian Tube Function Tests in Adults

Doyle

Swarts

Banks

et al. 2013

JAMA Otolaryngol Head Neck Surg

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Objective Determine if Eustachian Tube (ET) function (ETF) tests can identify ears with physician-diagnosed ET dysfunction (ETD) in a mixed population at high sensitivity and specificity and define the inter-relatedness of ETF test parameters. Methods ETF was evaluated using the Forced-Response, Inflation-Deflation, Valsalva and Sniffing tests in 15 control ears of adult subjects after unilateral myringotomy (Group I) and in 23 ears of 19 adult subjects with ventilation tubes inserted for ETD (Group II). Data were analyzed using logistic regression including each parameter independently and then a step-down Discriminant Analysis including all ETF test parameters to predict group assignment. Factor Analysis operating over all parameters was used to explore relatedness. Results The Discriminant Analysis identified 4 ETF test parameters (Valsalva, ET opening pressure, dilatory efficiency and % positive pressure equilibrated) that together correctly assigned ears to Group II at a sensitivity of 95% and a specificity of 83%. Individual parameters representing the efficiency of ET opening during swallowing showed moderately accurate assignments of ears to their respective groups. Three factors captured approximately 98% of the variance among parameters, the first had negative loadings of the ETF structural parameters, the second had positive loadings of the muscle-assisted ET opening parameters and the third had negative loadings of the muscle-assisted ET opening parameters and positive loadings of the structural parameters. Discussion These results show that ETF tests can correctly assign individual ears to physician-diagnosed ETD with high sensitivity and specificity and that ETF test parameters can be grouped into structural-functional categories.

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“…On the other hand, the tubal lumen in healthy subjects is opened periodically and for short time intervals by contraction of the Tensor Veli Palatini muscle during swallowing and other activities thereby allowing for gradient-driven gas transfers between the middle ear and nasopharynx which equalize the pressures in those compartments (pressure-regulating function) 2 . Studies in animals and humans show that low Eustachian tube periluminal pressures are associated with a susceptibility to the development of acute otitis media 3-5 and to otitis media with effusion 6 , and that inefficient muscle-assisted tubal opening is associated with a susceptibility to the development of chronic otitis media with effusion 7-10 .…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of the Forced Response Test in Children With Chronic Otitis Media With Effusion

Doyle

Mandel²,

Seroky³

et al. 2013

Otology &Amp; Neurotology

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Hypothesis Eustachian tube function is stable over time in children with ventilation tubes for chronic otitis media with effusion. Background Clinical studies report that Eustachian tube function tests in patients with a persistent tympanic membrane perforation predict the success of myringoplasty and, in patients with ventilation tubes for chronic otitis media predict disease recurrence after the tubes become nonfunctional. In those studies, Eustachian tube function was usually tested only once which presumes a semi-stable basal level of function for greatest diagnostic and prognostic usefulness. We investigated the stability of repeated measurements of Eustachian tube function using the Forced Response Test. Methods Thirty-nine children aged 36 to 83 months with bilateral ventilation tubes for chronic otitis media with effusion were evaluated using the Forced Response Test three times at three to four month intervals. The variability across test-sessions in the Eustachian tube opening pressure, closing pressure and dilatory efficiency was estimated using regression/correlation analyses. Results For all test parameters, the between-session and between-ear correlation coefficients were significant, but the shared variance in the parameters among test-sessions and between-ears at the same test-session was relatively low. The average slope for each parameter as a function of the time with a ventilation tube was zero. Conclusion The low between-test shared variance for the test parameters raises questions as to whether or not a single Forced Response Test captures sufficient information to accurately diagnose the cause of any dysfunction or to predict with high specificity and sensitivity future disease experience or surgical results.

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Eustachian tube closing failure in children with persistent middle ear effusion

Cited by 33 publications

References 12 publications

Physiology and Pathophysiology of Air-Filled Ear Space and Eustachian Tube Function

Physiology and Pathophysiology of Air-Filled Ear Space and Eustachian Tube Function

Sensitivity and Specificity of Eustachian Tube Function Tests in Adults

Reproducibility of the Forced Response Test in Children With Chronic Otitis Media With Effusion

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