Evaluation of Eustachian Tube Function by Contrast Roentgenography

Honjo, Iwao; Ushiro, Koichi; Okazaki, Nobuhiro; Kumazawa, Tadami

doi:10.1001/archotol.1981.00790420024005

Cited by 15 publications

(10 citation statements)

References 5 publications

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“…One of these is pumping of fluid out of the middle ear, through the eustachian tube, into the nasopharynx, by repeated swallowings, with repeated contractions of the tensor veli palatini muscle [Honjo et al, 1981[Honjo et al, , 1985. In the present study, this muscle pumping mechanism was prevented by drug-induced muscle paralysis.…”

Section: Discussionmentioning

confidence: 52%

“…In both cases, normal middle ear function and hearing require the clearance of this incompressible fluid and its replacement by compressible air. Several mechanisms have been implicated in this clearance: a pumping action through the eustachian tube following contraction of the tensor veli palatini muscle [Cantekin et al, 1979;Honjo et al, 1981Honjo et al, , 1985; removal by the beating cilia of the mucosal lining (mucociliary mechanism) of the middle ear and eustachian tube [Sade, 1967;Nuutinen et al, 1983]; osmotic outflow of water from the middle ear as a consequence of osmotic pressure gradients between the middle ear fluid and blood [Priner et al, 2003]; active transport of sodium by middle ear epithelium from the middle ear fluid, driving water absorption [Herman et al, 1992;Yen et al, 1993;Li et al, 2005].…”

Section: Introductionmentioning

confidence: 99%

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Mechanism and Rate of Middle Ear Fluid Absorption

Petrova

Freeman²,

Sohmer³

2007

Audiol Neurotol

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Several mechanisms have been suggested to explain the clearance of fluids from the middle ear. These include a pumping action through the eustachian tube, mucociliary beating through the tube, outflow of water to the blood due to osmotic gradients and an active Na⁺ transport driving water absorption. In order to assess these mechanisms, the middle ear cavity of paralyzed, ventilated (eustachian tube occluded) guinea pigs was filled with fluids varying in osmotic pressure (hypotonic, isotonic, hypertonic) to which a vertical tube was attached. The change in height of fluid in the tube was taken as a measure of changes in middle ear fluid volume. A greater fluid volume reduction was seen with the hypotonic (1/5 saline) solution. A small volume increase was observed with the hypertonic solution. These results provide evidence that in these experimental conditions, water absorption due to osmotic gradients can contribute to middle ear fluid clearance.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Mechanism and Rate of Middle Ear Fluid Absorption

Petrova

Freeman²,

Sohmer³

2007

Audiol Neurotol

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“…Previous studies have shown both antegrade and retrograde passage of CM through the ET . Our study contributes knowledge regarding safety, CT parameters, and CM volume and dilution.…”

Section: Discussionmentioning

confidence: 99%

CT imaging of the eustachian tube using focal contrast medium administration: a feasibility study

Falkenberg-Jensen

Silvola

Laurvik³

et al. 2016

Laryngoscope Investig Oto

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ObjectivesWe aim to develop an imaging technique for visualization of the Eustachian tube (ET) lumen.Study DesignA prospective, experimental study in an animal model and in human cadaver specimens.MethodsApplying iodixanol to the middle ear in two human temporal bone specimens, followed by computed tomography (CT) examinations, we optimized contrast dilution, CT algorithm, and head positioning for visualization of contrast passage through the ET.Myringotomy was performed on eight rabbits. Based on the cadaver study, a 20% iodixanol solution was applied to the middle ear, and subsequent CT scans were performed to observe iodixanol in the epipharynx. For some animals, the procedure was repeated on the contralateral ear. We performed the procedure twice on four subjects. Twenty examinations were included.Iodixanol appearance in the ET and the epipharyngeal orifice was assessed qualitatively on CT scans. The tympanic membrane was inspected after 1 or 2 weeks, and histopathological examination of six contrast‐exposed temporal bones was performed.ResultsThe cadaver study provided information on imaging technique and contrast dosage. In rabbits, iodixanol passed through the ET in 19 of the 20 ears. Qualitatively, optimal visualization was seen after 9 to 12 minutes. Clinical inspection after 1 or 2 weeks revealed normal middle ear status. Histopathological samples showed no sign of inflammatory reaction in the tympanic membrane, middle ear, or ET.ConclusionIodixanol application to the middle ear is feasible, safe, and demonstrates patency of the ET.Level of EvidenceN/A.

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“…Honjo et al [5] weisen darauf hin, dass beim Menschen immer noch wenig über die detaillierten Vorgänge beim Öffnen und Schlieûen der Tube bekannt sei.…”

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Morphologie, Funktion und Klinik der Tuba Eustachii

Pahnke¹

2000

Laryngorhinootologie

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Morphology, Function, and Clinic of the Eustachian Tube. Diagnostic and treatment of diseases of the Eustachian tube are difficult due to the deep position underneath the skull base and its oblique course. Several theories exist explaining the normal and disturbed function. Few sufficient tests for functional evaluation exist. Gross anatomical and microscopical features of the Eustachian tube gained from 30 sectional series were correlated with radioanatomical findings of high resolution magnetic resonance tomography (MRT) of 29 adult persons without ear disease. Differences to MRT of 31 patients with tubal disease or disturbed ear ventilation were evaluated. Tubal cartilage (TC), musculus tensor veli palatini (MTVP), and Ostmanns fat pad have a characteristical shape, that is correlated to normal function. The zone of physiological tubal closure is found in the vicinity of the isthmus. For precise imaging of these anatomical tubal structures using of special simple or double angulation of MRT-planes is necessary. Open tube disease often shows a typical atrophy of the Ostmans fat pad in the physiological closing zone. Causes of obstruction are found in different parts of the tube. Atrophy and hypertrophy of mucous membrane are also shown as a pathogenetic factor. In many cases disturbed function of the Eustachian tube is correlated to impaired anatomical structures which may be identified by MRT. Treatment should be planned according to afflicted structures. A synopsis of anatomy, physiology, and clinical characteristics is presented.

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Evaluation of Eustachian Tube Function by Contrast Roentgenography

Cited by 15 publications

References 5 publications

Mechanism and Rate of Middle Ear Fluid Absorption

Mechanism and Rate of Middle Ear Fluid Absorption

CT imaging of the eustachian tube using focal contrast medium administration: a feasibility study

Morphologie, Funktion und Klinik der Tuba Eustachii

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