SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Ear clearing

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Objective We aimed to perform a meta-analysis examining balloon dilatation and laser tuboplasty for the treatment of eustachian tube dysfunction (ETD). Data Sources PubMed, Cochrane, and Embase search up to April 18, 2016, with the following keywords: eustachian, middle-ear, eustachian tuboplasty, balloon tuboplasty, laser tuboplasty, laser dilatation, and balloon dilatation. Review Methods Randomized controlled trials and prospective, retrospective, and 1-arm studies of patients with ETD treated with balloon dilatation or laser tuboplasty were included. Outcome measures were improvement of eustachian tube score (ETS) and tympanometry and Valsalva maneuver results. Results Two retrospective and 11 prospective studies were included (1063 patients; 942 treated with balloon and 121 with laser tuboplasty). Balloon tuboplasty resulted in a significant improvement of ETS (pooled standardized mean difference [SMD], 0.94; 95% confidence interval [CI], 0.23-1.66; P = .009) and, compared with laser tuboplasty, a greater tympanometry improvement rate (pooled event rate = 73% vs 13%; P = .001). Valsalva maneuver improvement rate was not different between the group results (pooled event rate = 67% vs 50%; P = .472). The maximum number of studies that provided outcome data for any one measure was only 4, and sensitivity analysis indicated ETS results may have been overly influenced by 2 studies. No balloon tuboplasty studies reported ETS data, preventing comparison between the 2 procedures. Conclusion Both procedures can improve symptoms of ETD; however, because of the limited numbers of studies reporting data of the outcomes of interest, it remains unclear if one procedure provides greater benefits.

Concepts: Randomized controlled trial, Middle ear, Eustachian tube, Otitis media, Ear, Patulous Eustachian tube, Valsalva maneuver, Ear clearing

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The determination of Eustachian tube dysfunction (ETD) subtypes in daily routines is based on symptoms of the patient, otoscopy, nasopharyngoscopy, tympanometry, pure tone audiometry, and Valsalva’s test, even though this clinical assessment is often not sufficient to clearly diagnose the subtype. In the study, we have evaluated the possibility of the determination of different subtypes of ETD by pressure chamber measurements.

Concepts: Patient, Eustachian tube, Otitis media, Ear, Pure tone audiometry, Patulous Eustachian tube, Valsalva maneuver, Ear clearing

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The Eustachian tube protects against secretion, germs and sound pressure from the nasopharynx, it acts as a drain, and serves pressure equalization in both directions so that the ear drum and sound-conducting apparatus can vibrate optimally. The incidence of Eustachian tube dysfunction in adults is about 1%, in children almost 40%. Symptoms are often unspecific. For diagnosis, the Eustachian tube score (ETS-5) can be used in patients with a perforated ear drum, and the ETS-7 score in patients with intact ear drum. Adenoid hypertrophy is a frequent cause of obstructive tube dysfunction in children. Treatment of obstructive dysfunction includes steroid nasal sprays and regular performance of the Valsalva maneuver, as well as tube dilation with the Bielefelder balloon catheter. The patulous Eustachian tube is treated with saline nasal irrigation, estrogen-nasal ointment, and craniocervical manual therapy; causal treatments are evaluated.

Concepts: Auditory system, Middle ear, Eustachian tube, Ear, Nasal irrigation, Patulous Eustachian tube, Valsalva maneuver, Ear clearing

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We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT).

Concepts: Auditory system, Eustachian tube, Underwater diving, Scuba diving, Barotrauma, Ear clearing

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We investigated in a prospective, observational trial the feasibility of using the Eustachian tube function test (ETFT) to measure the effect of repetitive pressure exposure during open seawater dives on Eustachian tube function.

Concepts: Oxygen, Eustachian tube, Pressure, Seawater, Underwater diving, Scuba diving, Barotrauma, Ear clearing

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Eustachian tube dysfunction has been associated with most cases of middle-ear disease. We aimed to assess the effectiveness of dynamic slow motion video endoscopy (DSVE) as a test of eustachian tube dysfunction. Furthermore, we assessed the correlation of the test with the Valsalva maneuver, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and intraoperative findings of the eustachian tube.

Concepts: Middle ear, Eustachian tube, Otitis media, Ear, Pseudoephedrine, Patulous Eustachian tube, Valsalva maneuver, Ear clearing

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There is no agreement on the best clinical test for Eustachian tube (ET) dysfunction. Numerous tests have been developed to detect ET opening, and all require a patient to perform a Valsalva, Toynbee or sniff maneuver, or to swallow on demand. We aimed to characterize existing tests of ET function in healthy ears, and identify the optimal method and patient maneuver for each test. Our own normative data is presented alongside published comparisons.

Concepts: Clinical trial, Auditory system, Eustachian tube, Ear, Social sciences, Normative, Valsalva maneuver, Ear clearing

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Balloon eustachian tuboplasty (BET) has entered clinical use as a treatment for eustachian tube dysfunction. Some surgeons perform myringotomy prior to BET due to concerns that the increase in middle ear (ME) pressure caused by BET may cause otic barotrauma. We investigated the ME pressure changes occurring during BET in cadavers.

Concepts: Auditory system, Middle ear, Eustachian tube, Otitis media, Ear, Patulous Eustachian tube, Barotrauma, Ear clearing

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This article discusses the authors' approach to the assessment of the eustachian tube using opening pressure measurement, endoscopic assessment of the protympanic segment of the eustachian tube, and Valsalva computed tomography. A possible algorithm for the evaluation of eustachian tube obstructive disorders is detailed both preoperatively and intraoperatively.

Concepts: Auditory system, Eustachian tube, Ear, Underwater diving, Valsalva maneuver, Ear clearing