Change of Tympanogram after Chronic Otitis Media Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Pre-operative eustachian tube function (ETF) is an important factor for the postoperative success after tympanoplasty, though much debates have been reported. In this study, we investigated the tympanogram changes after tympanoplasty, indirectly checking up ETF, to find out the relationship between tympanogram changes and associated factors of tympanoplasty. SUBJECTS AND METHOD: Included in this study were 238 cases of tympanoplasty (canal wall up mastoidectomy with tympanoplasty type I or tympanoplasty type I only) performed by one surgeon for chronic otitis media from January, 2012 to June, 2017. In all cases, tympanometric tests were undertaken at one month, three month, six month, and one year post-operatively, and pure tone audiometry tests were taken at 1 year, post operatively. RESULTS: The average hearing level and air-bone gap were 41.8±19.7 dB, and 17.1±9.3 dB, pre-operatively, and 29.9±21.1 dB, and 6.9±8.5 dB, 1 year post-operatively, respectively. Most of the cases showed improvement in hearing. The results of tympanometry showed that hearing improvement was greater for the A type than for the B or C type (p<0.001). The smaller the size of the tympanic membrane was, the higher, the type A tympanogram appeared to be (p=0.008). CONCLUSION: The estimation of pre-operative ETF using post-operative tympanogram changes can give insight to the degree and process of recovery of the normal middle ear after tympanoplasty.

Dynamic Slow Motion Video Endoscopy as an Adjunct to Impedance Audiometry in the Assessment of Eustachian Tube Function

Abstract Introduction Eustachian tube (ET) dysfunction plays an important role not only in the pathophysiology of various middle ear disorders, but also in predicting the outcome of the treatment. As there is no single test that assesses both the anatomic and physiological functions of the ET, a combination of tympanometry and dynamic slow motion video endoscopy may improve the sensitivity of ET function assessment. Objective To find out if there is any correlation between dynamic slow motion nasal video endoscopy and impedance audiometry in assessing ET function in patients with middle ear diseases. Methods Ours was a descriptive study performed with 106 patients attending the Ear, Nose and Throat (ENT) Outpatient Department of a tertiary care center in South India with features suggestive ofmiddle ear disease. All patients underwent impedance audiometry and dynamic slow motion nasal video endoscopy, and were graded based on the severity of the ET pathology. Results A total of 47 out of 97 patients with abnormal endoscopy findings also had abnormal impedance audiometry. The correlation was greater among the patients with higher grades of ET dysfunction. The endoscopy findings of 106 cases, when correlated with middle ear manometry, revealed that 56 cases showed complete agreement, and 50 cases showed disagreement. The nasal endoscopy results, when correlated with middle ear manometry studies by using McNemar's chi-squared (χ2) test, showed a significant association between the 2 tests (p = 0.017). Conclusion There is a significant alteration in middle ear pressure as the severity of the ET tube dysfunction increases. Impedance audiometry and nasal endoscopy provide a better measure of ET function.

Clinical research on consistency of different evaluation methods for eustachian tube function and surgery exploration / 局解手术学杂志

Objective To compare the consistency of temporal bone HRCT,tympanium drip method,impedance audiometry for eustachian tube function and exploratory surgery,and to determine the best method for evaluation of eustachian tube function.Methods The examination of the eustachian tube function were given on 68 cases of otitis media with the surgical indication by these three methods above-mentioned in turn.And then compare the evaluation results with the exploratory surgery.Results The count data matching test of temporal bone HRCT,tympanium drip method and impedance audiometry compare with surgery exploration results were κ =0.625,κ =0.472,κ =0.912,respectively,which were in general degree(κ≥0.4).It suggested that the three methods were reliable for evaluation of eustachian tube function.Conclusion Among these three methods,impedance audiometry is the most accurate one,and then temporal bone functional HRCT,the last one is tympanium drip,therefore,the method of impedance audiometry is promoted to evaluate the function of eustachian tube.

The exploration of TTAG method in determinating the states of Eustachian tube functiong of healthy group / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the feasibility and validity of tubo-tymanoaerodynamic graphy(TTAG)determinating the Eustachian tube function of health adult group.Mthod:The ventilation function of Eustachian tube was measured by the TTAG method in health adlut group(132 ears),the results and the graphs were also analyzed.Reslut:The positive rate in health adult group using Valsalva method was 93.93%(124/132).The positive ears were divided into typeⅠand typeⅡ, the mean value of nasopharynx press of type Ⅰand Ⅱ has no significant differences(P>0.05),but the mean value of external auditory canal press had significant differences(P<0.01).Conclusion:TTAG meathod has the clinical value in determinating the states of Eustachian tube function of health group.

Effect of iontophoresis anesthesia of the tympanic membrane on middle ear pressure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES:The presence of encapsulated nerve corpuscles that is involved in regulating middle ear pressure has been noticed in previous studies. Based on those findings, how the sensory receptors in the tympanic membrane and tubal function are related was tested in the present study. MATERIALS AND METHODS: Tubal function was tested by 9 step test using Grason-Stadler institute(GSI) Middle ear analyzer II Eustachian tube function(ETF) test mode. Tubal function was recorded as compliance of the tympanic membrane on an otoadmittance meter. To anesthetize the sensory receptors in the tympanic membrane, iontophoresis was applied to the twenty right ears of the twenty subjects. RESULTS: Peak pressure difference in the middle ear was reduced after the tympanic membrane (TM) anesthesia, which indicates that the tubal function has decreased due to pressure change in the sensory receptors in the tympanic membrane. CONCLUSION: The findings of the present study suggest that there may be a neural connection between the sensory receptors in the tympanic membrane and the tubal muscle, as the eustachian tube function changed following the TM anesthesia.