Eustachian tube function in chronic otitis media with effusion

Since return of normal ventilation of middle car is a prerequisite to maintain an effusion-free ear state, it was our objective to study tubal function in patients with chronic otitis media with effusion [OME] that had been treated by ventilation tubes [VT]. A prospective study was conducted on 63 patients [105 ears] with chronic OME and treated by VT. The tubal function was investigated by the inflation-deflation method, and then by nasal endoscopy. The correlation between manometric and endoscopic results may have implications on management of chronic OME. The first group [9 ears in 6 patients] had normal tubal function with 11.1% effusion recurrence rate. The second group [54 ears in 36 patients] had organic obstruction. Normalization of tubal function by correction of peritubal pathology could be achieved in 42 ears in whom the effusion recurrence rate was 14.3%. In the remaining 12 ears with persistent tubal dysfunction, reintubation may be necessary after spontaneous extrusion in 83.3% of cases. The third group [42 ears in 21 patients] has functional obstruction with 78.6% effusion recurrence rate. Correction of organic tubal obstruction must precede VT removal to prevent recurrence of effusion. Nasal endoscopy proved to be indispensable in diagnosing, localizing and even treating "hidden" lesions in their key areas. Whenever tubal obstruction is diagnosed as functional or idiopathic, ventilation of middle ear should be maintained by frequent intubation or insertion of long-term VT, and a guarded prognosis given

role of pharyngeal repair on acoustic characteristics of tracheoesophageal voice

The tracheoesophageal puncture [TEP] technique for voice restoration is a successful way of providing voice rehabilitation after total laryngectomy. Because postoperative voice quality can vary significantly depending on which type of hypopharyngeal repair is chosen, the aim of this work was to evaluate the effect of these repairs on the TEP voice after total laryngectomy. In this study, the TEP voice was quantitatively and qualitatively evaluated in 20 patients using Provox 2 A registerd prosthesIs after standard total laryngectomy. The patients were divided according to the type hypopharyngeal repair into four groups [five cases for each]; A: pharyngoesophageal myotomy, B: pharyngeal plexus neurectomy, C: non-muscle repair, and D: transverse repair. The groups were compared with each other for different voice parameters. The acoustic results of the four pharyngeal repair groups did not reveal significant difference for most of the voice parameters. Primary TEP voice restoration is recommended as it offers several advantages; 1. I simple, effective and not time consuming, 2. It is a low morbidity procedure, 3. It is cost effective as it eliminates a secondary procedure for voice restoration and reduces prolonged speech therapy sessions, 4. Early voice production gives the patient a psychological boost which improves convalescence. All used methods of pharyngeal repair succeeded to prevent postoperative neopharyngeal spasm