Assessment of eustachian tube dysfunction in middle ear pathologies

Abstract

Background: Auditory tube dysfunction is suspected as primary cause of chronic otitis media and leads to surgical related complications in otitis media with tympanic membrane perforation. The diagnosis of eustachian tube malfunction is essential to know the pathogenesis of chronic otitis media.

Methods: A total 150 cases and 75 age, sex matched control subjects between age group 20-50 years were selected. Pre and post-surgical history was noted and detailed ear examination, tympanometry was done. Auditory tube function was evaluated through Valsalva test, nasopharyngoscopy, pneumatic otoscopy. Intact tympanic membrane was assessed by Williams test, perforated tympanic membrane by Toynbee’s test.  

Results: Postoperative assessment of eustachian tube function by Toynbee’s test for 19 cases with failed tympanoplasty showed normal ET function in 5 cases, 8 cases had partial and 6 cases had gross ET dysfunction. Postoperative assessment ET function by William’s test showed 4 cases among 19 cases had partial ET dysfunction and 01 cases had gross ET dysfunction.

Conclusions: Efficient surgical outcome of middle ear complications always depends on eustachian tube function. Most of the cases with residual CP showed partial or gross ET dysfunction. Patients with tubal dysfunction should be evaluated for underlying cause and treatable causes should addressed before proceeding for surgery as it increases the success rate of tympanoplasty.