Long-term middle ear pressure measurements in inner ear disorders

Abstract

Significant negative middle ear pressure were seen in patients with Meniere's disease compared with patients with sudden hearing loss and healthy subjects (p < 0.01). Average middle ear pressure in patients with Meniere's disease was -43 daPa, in patients with sudden hearing loss it was 2 daPa, and in healthy subjects it was 4 daPa. Patients with Meniere's disease showed a large variability of pressure values ranging from strongly pathological to normal values during long-term measurements.

The Curious ‘Type C’ Tympanogram: Contraction of the Tensor Tympani Masquerades as Negative Middle Ear Pressure

“…A striking result that reinforces the muscle interpretation is the study by Park [19] of middle ear pressure in normal and in Meniere's patients. It has already been suggested that Meniere's disease is caused by excessive activity of the tensor tympani [4], so it is highly relevant that the mean middle ear pressure of 30 normals was found to be 4 daPa (±5 daPa) whereas the figure for 33 Meniere's patients was -43 daPa (±75 daPa).…”

“…Intriguingly, however, a later paper by one of the same authors [23] backs away from the association between negative middle ear pressure and Meniere's, claiming only that, based on a larger sample, the incidence of Type C (or B) tympanograms was only about the same as what Jerger found in normals. We are not told much about the change in outlook apart from enlarged numbers, but given the strong findings of the earlier work, and the equally strong findings reported later by Park (2012) [19], one might reasonably suspect that something peculiar is going on and that perhaps a key factor may have been missed. Closer investigation might provide the necessary clues, and in any such work the tensor tympani hypothesis stands as a good candidate for resolving these peculiar anomalies.…”

The aetiopathologies of Ménière’s disease: a contemporary review

“…Furthermore, Morinaka and Nakamura found an increased difference of middle ear pressure between bilateral ears in MD patients 90 . Finally, patients with MD showed on average a significant negative middle ear pressure, - 43 decapascals, compared with healthy subjects and patients with sudden hearing loss 91 . Given these findings, due to the previously described importance of the cochlear aqueduct and its functional anatomic proximity to the round window, inner ear disorders such as ELH present conditions in which abnormal middle ear pressures might trigger or worsen vertigo attacks.…”

Revisiting the Diagnostic Performance of the Modified Nine-Step Test for Obstructive and Patulous Eustachian Tube Dysfunction

“…The abnormal middle ear pressure (type C tympanogram) is generally defined as below −100 daPa [19,20]. However, other studies have also defined abnormal middle ear pressure as below −50 daPa [9][10][11]17,21]. More recently, a prospective study by Parsel et al suggested a cut-off value for abnormal middle ear pressure to be between 25-50 daPa [22].…”

“…The oETD group consisted of 19 ears from 14 patients. Additional inclusion criteria for the oETD group were (1) presentation of typical symptoms; and (2) middle ear pressure below −50 daPa or retracted tympanic membrane [9][10][11]. The exclusion criteria were (1) perforated tympanic membrane; (2) otitis media; and (3) not having a distinctive peak in impedance audiometry (e.g., type B).…”