Eustachian tube function in chronic otitis media with effusion

ABSTRACT

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