Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients

ObjectivesThe Eustachian tube (ET) plays an important role in maintaining a normally aerated middle ear. Inflammation in middle ear disease is related to ET dysfunction, and postoperative restoration of middle ear integrity and hearing are closely related to ET function in chronic ear disease patien...

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Main Authors: Seung Hyo Choi, Ju Hee Han, Jong Woo Chung
Format: Article
Language:English
Published: Korean Society of Otorhinolaryngology-Head and Neck Surgery 2009-06-01
Series:Clinical and Experimental Otorhinolaryngology
Subjects:
Online Access:http://www.e-ceo.org/upload/pdf/ceo-2-61.pdf
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author Seung Hyo Choi
Ju Hee Han
Jong Woo Chung
author_facet Seung Hyo Choi
Ju Hee Han
Jong Woo Chung
author_sort Seung Hyo Choi
collection DOAJ
description ObjectivesThe Eustachian tube (ET) plays an important role in maintaining a normally aerated middle ear. Inflammation in middle ear disease is related to ET dysfunction, and postoperative restoration of middle ear integrity and hearing are closely related to ET function in chronic ear disease patients. After successful tympanoplasty, restoration of a well-aerated middle ear with good ET function can permit better compliance of the tympanic membrane. In this study, we evaluated the predictive validity of preoperative ET function measurements.MethodsWe reviewed 137 patients who underwent type 1 tympanoplasty. All patients had non-cholesteatomatous chronic otitis media and received canal wall-up-type tympanomastoidectomies. Patients were categorized into four groups according to preoperative ET function measurements using a modified pressure inflation-deflation equilibration test. Group I patients had residual pressures less than 10 daPa, and Group IV patients showed no pressure change (poor results). Groups II and III were intermediate. Hearing levels were determined using pure tone averages at four frequencies. Postoperative tympanography was performed to determine middle ear aeration.ResultsThe preoperative air bone (AB) gap was 29.6±7.0 dB, and the postoperative gap was 16.5±5.7 dB; thus, there was significant overall improvement. In all groups, hearing was significantly better after surgery, but the worst postoperative hearing level was seen in Group IV patients. Type B tympanograms were more frequently recorded in Group IV patients than they were in Group I or II patients. Postoperative AB gaps were 9.2±3.8 dB in patients with type A tympanograms, 13.4±2.1 dB in those with type As, 24.1±2.5 dB in those with type C, and 18.5±2.8 dB in those with type B.ConclusionET function measured with a modified pressure equilibration test using an inflation-deflation manometric method is a good indicator of an aerated middle ear and is predictive of improved postoperative hearing.
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spelling doaj.art-427971c8f76d4cb982174d0ee16c7aeb2022-12-22T00:08:32ZengKorean Society of Otorhinolaryngology-Head and Neck SurgeryClinical and Experimental Otorhinolaryngology1976-87102005-07202009-06-0122616510.3342/ceo.2009.2.2.6175Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty PatientsSeung Hyo Choi0Ju Hee Han1Jong Woo Chung2Department of Otolaryngology, Jeju National University Hospital, Jeju National University, College of Medicine, Jeju, Korea.Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ObjectivesThe Eustachian tube (ET) plays an important role in maintaining a normally aerated middle ear. Inflammation in middle ear disease is related to ET dysfunction, and postoperative restoration of middle ear integrity and hearing are closely related to ET function in chronic ear disease patients. After successful tympanoplasty, restoration of a well-aerated middle ear with good ET function can permit better compliance of the tympanic membrane. In this study, we evaluated the predictive validity of preoperative ET function measurements.MethodsWe reviewed 137 patients who underwent type 1 tympanoplasty. All patients had non-cholesteatomatous chronic otitis media and received canal wall-up-type tympanomastoidectomies. Patients were categorized into four groups according to preoperative ET function measurements using a modified pressure inflation-deflation equilibration test. Group I patients had residual pressures less than 10 daPa, and Group IV patients showed no pressure change (poor results). Groups II and III were intermediate. Hearing levels were determined using pure tone averages at four frequencies. Postoperative tympanography was performed to determine middle ear aeration.ResultsThe preoperative air bone (AB) gap was 29.6±7.0 dB, and the postoperative gap was 16.5±5.7 dB; thus, there was significant overall improvement. In all groups, hearing was significantly better after surgery, but the worst postoperative hearing level was seen in Group IV patients. Type B tympanograms were more frequently recorded in Group IV patients than they were in Group I or II patients. Postoperative AB gaps were 9.2±3.8 dB in patients with type A tympanograms, 13.4±2.1 dB in those with type As, 24.1±2.5 dB in those with type C, and 18.5±2.8 dB in those with type B.ConclusionET function measured with a modified pressure equilibration test using an inflation-deflation manometric method is a good indicator of an aerated middle ear and is predictive of improved postoperative hearing.http://www.e-ceo.org/upload/pdf/ceo-2-61.pdfEustachian tubeTympanoplastyHearingMiddle ear ventilationAcoustic impedance testsTympanic membrane perforation
spellingShingle Seung Hyo Choi
Ju Hee Han
Jong Woo Chung
Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
Clinical and Experimental Otorhinolaryngology
Eustachian tube
Tympanoplasty
Hearing
Middle ear ventilation
Acoustic impedance tests
Tympanic membrane perforation
title Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
title_full Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
title_fullStr Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
title_full_unstemmed Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
title_short Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients
title_sort pre operative evaluation of eustachian tube function using a modified pressure equilibration test is predictive of good postoperative hearing and middle ear aeration in type 1 tympanoplasty patients
topic Eustachian tube
Tympanoplasty
Hearing
Middle ear ventilation
Acoustic impedance tests
Tympanic membrane perforation
url http://www.e-ceo.org/upload/pdf/ceo-2-61.pdf
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