Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation

Ilan, Ophir; El, Marcus; Cohen, Yves; Farkash, T; Levy, Rivka; Sasson, Ady; Adelman, Cahtia

doi:10.1017/s0022215117001554

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…While chronic adenoiditis and rhinosinusitis are known risk factors for ETD, these causes of nasal airway obstruction also contribute an inflammatory component to the dysfunction of the Eustachian tube. Although some studies have demonstrated that increased nasal obstruction from purely anatomic causes, such as septal deviation (Kaya et al, 2018) and inferior turbinate hypertrophy (Harju, et al, 2017), can contribute to ETD, other studies show little to no effect in patients with tracheostomy (Meric et al, 2012) or laryngectomy (Ilan et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Impact of Surgery for Velopharyngeal Insufficiency on Eustachian Tube Function in Children: Pharyngeal Flap Versus Sphincter Pharyngoplasty

Fuller

Brown

Speed

et al. 2021

The Cleft Palate-Craniofacial Journal

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Objective: Velopharyngeal insufficiency (VPI) is a common speech disorder in patients with a history of cleft palate (CP) or 22q11.2 deletion syndrome. Pharyngeal flap (PF) and sphincter pharyngoplasty (SP) are 2 common surgeries to treat this disorder by decreasing unwanted nasal air emission and hypernasal resonance. Because Eustachian tube dysfunction (ETD) in patients with CP may be more frequent after surgery for VPI, we examined whether ETD was associated with either type of surgery. Design: Retrospective cohort study. Setting: Children’s hospital-based tertiary referral center. Patients: A total of 225 children with VPI who underwent primary PF (201) or SP (24) between 2006 and 2017. Outcome measures: We examined differences in risk of ETD according to both surgical groups and proxies for postoperative nasal obstruction. These proxies included postoperative resonance measures and development of obstructive sleep apnea (OSA). Results: Both surgical groups had similar preoperative measures, except the PF group had higher hypernasality by PSA. Postoperatively, the PF group demonstrated lower hypernasal resonance by nasometry and PSA. There were no differences between PF and SP groups with regard to ETD. Proxies for postoperative nasal obstruction also were not predictive of postoperative ETD. Degree of CP and younger age were found to be risk factors for ETD. Conclusion: There was no significant difference in the effects of PF and SP on ETD in this study. Neither lower hypernasality nor incidence of OSA had any impact on ETD. Degree of CP and younger age were the only significant risk factors for ETD that this study identified.

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Section: Discussionmentioning

confidence: 99%

Impact of Surgery for Velopharyngeal Insufficiency on Eustachian Tube Function in Children: Pharyngeal Flap Versus Sphincter Pharyngoplasty

Fuller

Brown

Speed

et al. 2021

The Cleft Palate-Craniofacial Journal

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show abstract

“…Improvements in techniques and surgical instruments to minimize the need for resection and damage to adjacent structures in the skull base may improve the postoperative quality of life 19 . The Eustachian tube is of critical importance for middle ear function including pressure regulation and hearing 20 . Although tympanostomy and tube insertion can solve the pressure dysfunction, potential hearing loss and worsened middle ear function are still of concern 13,21 .…”

Section: Discussionmentioning

confidence: 99%

“…19 The Eustachian tube is of critical importance for middle ear function including pressure regulation and hearing. 20 Although tympanostomy and tube insertion can solve the pressure dysfunction, potential hearing loss and worsened middle ear function are still of concern. 13,21 Therefore, efforts to preserve the function of the Eustachian tube are desirable.…”

Section: Discussionmentioning

confidence: 99%

Role of resection of torus tubarius to maximize the endonasal exposure of the inferior petrous apex and petroclival area

London

Prevedello

et al. 2020

Head & Neck

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Endoscopic access to the petrous apex and petroclival region often requires sacrificing the Eustachian tube (ET). This study aimed to compare the maximum exposure of the petrous apex and petroclival region via an endonasal corridor when sparing or resecting the ET and its torus. Six cadaveric specimens (12 sides) were dissected through an endonasal transpterygoid approach. Endonasal exposure of the petroclival region was completed using techniques that included the preservation of the ET (group 1), resection of the torus tubarius (group 2), and resection of the ET (group 3) were sequentially performed on each side. The working distances from the anterior genu of the petrous internal carotid artery (ICA) to the inferior boundaries of each corridor were measured and compared. In group 1, the medial petrous apex and petroclival sulcus could be exposed with a working distance of 4.08 ± 0.67 mm. In group 2, the fossa of Rosenmüller, inferior petrous apex, and hypoglossal canal could be exposed, with a significantly increased working distance of 18.33 ± 0.89 mm (P = .001). In group 3, the exposure and ICA control was superior and offered a working distance of 20.67 ± 0.78 mm. No statistically significant difference derived from comparing groups 2 and 3 (P = .875). Resection of the torus tubarius can increase exposure of the petrous apex and petroclival region. It provides an alternative to resecting the ET, which might be beneficial for maintenance of middle ear function. ET resection, however, seems superior when ICA control is required.

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Cholesteatoma in the pediatric aerodigestive population

Ma,

Ceremsak,

Wootten

2024

International Journal of Pediatric Otorhinolaryngology

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Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation

Abstract: Middle-ear pathology is common in patients on chronic mechanical ventilation via tracheostomy tube. The highest prevalence was in those with impaired consciousness or cognition, and oral feeding appeared protective.

Cited by 4 publications

References 17 publications

Impact of Surgery for Velopharyngeal Insufficiency on Eustachian Tube Function in Children: Pharyngeal Flap Versus Sphincter Pharyngoplasty

Impact of Surgery for Velopharyngeal Insufficiency on Eustachian Tube Function in Children: Pharyngeal Flap Versus Sphincter Pharyngoplasty

Role of resection of torus tubarius to maximize the endonasal exposure of the inferior petrous apex and petroclival area

Cholesteatoma in the pediatric aerodigestive population

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