Evaluation of Eustachian tube function with perfect sequences: technical realization and first clinical results

Abstract

The aim of this study was the introduction of a specific class of signals, the so-called perfect sequences (PSEQ), in a novel approach for sonotubometry of the Eustachian tube (ET). Sonotubometry using PSEQ stimuli was performed on 20 healthy subjects in order to gauge its potential for clinical applications. In a series of 320 measurements ET opening was probed, which was induced by dry and water swallowing, Toynbee maneuver, and yawning. All sonotubograms were analyzed with respect to their shape, increase of sound intensity, and opening duration. In 298/320 measurements (>93%) the subjects reported subjective ET openings. The evaluation of the recorded sonotubograms showed good detection of ET opening for the inducing maneuvers of swallowing (dry and water swallowing) and the Toynbee maneuver, with 90, 86, and 80% valid sonotubograms, respectively. Yawning led to only 40% valid sonotubograms. In total, 237/320 (~74%) sonotubograms were classified as valid. The evaluation of the sound level increase during ET openings showed that it was significantly higher in measurements with dry and water swallowing, as well as Toynbee maneuvers (mean 17.1, 19.0 and 17.2 dB, respectively), than with yawning (mean 10.17 dB; P < 0.0001). Nasal decongestion was found to have little influence on the results (P > 0.05). Sonotubometry using PSEQ stimuli is a novel sonotubometry methodology that provides valuable information regarding the auditory tube patency. By further technical refinements of the method, a diagnostic tool with high sensitivity and specificity could be developed.

Impact of Xylomethazoline on Eustachian Tube Function in Healthy Participants

“…Intranasal decongestant therapy in healthy participants has been evaluated only in a few studies and small cohorts (25,33). Via sonotubometry, Duplessis et al (25) had shown a significant lower ETOP after using intranasal oxymethazoline versus saline placebo ( p = 0.04) in eight divers during repetitive multiday diving.…”

“…The results of this study should however be interpreted carefully given the small sample size of the study cohort. In addition, in a study in 2010, Di Martino et al (33) reported that nasal decongestants had no significant influence on the ET concerning the ET function in swallowing, yawning, and Toynbee maneuver measured by sonotubometry.…”

Deleterious sucking habits and atypical swallowing in children with otitis media with effusion

“…For this reason, an impaired ET is an important factor in the pathogenesis of various middle ear diseases [14]. Moreover there are studies showing that active opening of the Eustachian tube which in turn regulate the middle ear pressure is primarily provided by contraction of mTVP during swallowing [15]: a defect in the functioning of the mTVP, which is shown to be the most effective muscle in the opening of nasopharyngeal orifice in a number of studies, may be one of the causes of obstructive tubal dysfunction.…”

Eustachian tube and middle ear mechanics

“…perfekter Sequenzen (PSEQ) zu diesem Zweck gewidmet. In ersten Publikationen [42,43] weisen sie die Anwendbarkeit des Verfahrens nach. So wurden v. a. beim Schlucken (trocken oder mit Wasser) sowie beim Toynbee-Manöver in hohem Maß Tubenöffnungen richtig detektiert (zwischen 80 und 90%), während die "Ausbeute" beim Gähnen mit ca.…”