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The impact of acute loss of weight on eustachian tube function.

ABSTRACT: Introduction The eustachian tube is one of the key structures responsible for the functional balance of the middle ear. Some clinical conditions associated with tubal malfunction can cause extremely unpleasant symptoms. These symptoms could be triggered by acute loss of weight, for example, after bariatric surgery. Objective To evaluate the frequency and intensity of auditory tube dysfunction symptoms in obese patients after bariatric surgery. Methods Nineteen patients with accepted formal indications for bariatric surgery underwent a hearing evaluation (otoscopy, tonal and vocal audiometry, and impedanceometry) and a hearing questionnaire before, at the time of, 3 months after surgery (first postoperative evaluation), and 6 months (second postoperative evaluation) after surgery. Patients with a history of ear disease or ear surgery were excluded. Results None of the patients reported tubal dysfunction symptoms before surgery. Postsurgical results showed that 5 (26.3%) patients presented symptoms related to dysfunction of the eustachian tube at the first postoperative evaluation. After the 6-month follow-up, 9 (47.3%) patients reported symptoms of tubal dysfunction. Conclusion This study suggests that bariatric surgery can cause symptoms of eustachian tube dysfunction, probably due to rapid weight loss and the consequent loss of peritubal fat.

SUBMITTER: Pascoto G

PROVIDER: S-EPMC4296987 | biostudies-other | 2014 Oct

REPOSITORIES: biostudies-other

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Navigation-Assisted Balloon Eustachian Tuboplasty for Eustachian Tube Dilatory Dysfunction.

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Denervation of the Eustachian Tube and Hearing Loss Following Trigeminal Schwannoma Resection.

Project description:Objectives To discuss eustachian tube dysfunction (ETD) as a cause of hearing loss and to discuss its pathogenesis following resection of trigeminal schwannomas. Methods Presented herein are two cases of trigeminal schwannoma that were resected surgically with sacrifice of the motor branch of the trigeminal nerve. Neither of the cases had evidence of extracranial extension nor preoperative ETD. Both patients developed ETD and have been followed without evidence of schwannoma recurrence. Conclusions Trigeminal schwannomas are rare tumors that typically require surgical resection. Hearing loss is a potential postsurgical deficit and warrants evaluation by an otolaryngologist with consideration given to a preoperative audiogram. ETD as a result of trigeminal motor branch sacrifice should be included in the differential diagnosis of postoperative hearing loss in this patient subset as it may be reversed with placement of a tympanostomy tube.

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Predictive value of the Eustachian Tube Dysfunction Questionnaire-7 for identifying obstructive Eustachian tube dysfunction: A systematic review.

Project description:ObjectiveTo perform a systematic review to determine if a total score of ≥14.5 (mean score ≥ 2.1) on the ETDQ-7 accurately identifies patients with obstructive Eustachian tube dysfunction (OETD) on impedance tympanometry (peak compliance <0.2 mL or middle ear pressure of -100 daPa) or other objective measures of OETD.MethodsA systematic review without a meta-analysis was performed of studies in four electronic databases (Pubmed, Embase, Web of Science, and Scopus) that used the ETDQ-7 and at least one objective measure of OETD.ResultsSix-hundred and fifty-two studies were identified in the initial literature search. Abstracts from 337 studies were screened, followed by full-text review of 61 studies, and qualitative synthesis of 12 studies. Tympanometry was used as an objective measure in ten studies. Eight of the 12 included studies had patient cohort selection bias. Eight studies administered the ETDQ-7 in cohorts of patients with or without OETD, already confirmed on tympanometry, and found a sensitivity of 91%-100% and specificity of 67%-100%. Four studies administered the ETDQ-7 to patients who had not previously undergone objective testing and found a sensitivity of 49%-80% and specificity of 24%-78%.ConclusionsThe ETDQ-7 is an important patient-reported outcome measure. However, based upon existing literature, the ETDQ-7 appears limited as a diagnostic tool for OETD or as an objective measure of Eustachian tube function.

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Three-dimensional finite element analysis of Eustachian tube function under normal and pathological conditions.

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Prospective study on the Eustachian tube function during Frenzel maneuver in a hypobaric/hyperbaric pressure chamber.

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Project description:Objectives:Foreign bodies of the external and middle ear are not uncommon; however, foreign bodies in the eustachian tube are rare. Here we describe the presentation, imaging, and endoscopic-assisted surgical management of a case of eustachian tube foreign body. Methods:A 34-year-old male was seen for evaluation of foreign body of the left eustachian tube while working with metal at a machine shop. Imaging and surgical management are highlighted and review of available literature regarding foreign bodies of the eustachian tube is presented. Results:A CT scan revealed a foreign body present approximately 1?cm into the bony eustachian tube. The patient underwent middle ear exploration which required endoscopic assistance to adequately visualize the foreign body. The foreign body was unable to be removed and required the creation of a bony tunnel lateral to the eustachian tube for visualization and access to the foreign body. Conclusions:This report presents a rare case of eustachian tube foreign body. Use of the endoscope during the surgical removal greatly enhanced the ease and safety of removal. This report also highlights the importance of ear protection with any machining and welding work.

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Project description:Chronic eustachian tube dysfunction is a condition that affects a large number of adults every year. While many cases can be managed pharmacologically, there is a significant portion that does not respond to medical treatment alone. Invasive methods from the aural side like grommet or tympanic tube insertion have complications associated with it and often cannot address the underlying condition of the nasopharyngeal side of the eustachian tube. Balloon eustachian tuboplasty (BET) is a minimally invasive intervention that has been used successfully in countries like Germany and USA in the past decade. This paper presents the experience of a new clinical user of BET in India by retrospectively looking at the outcomes of the first 10 patients on which the procedure was performed. A marketed product EustaCare was used for the cases. There was a 90% procedural success rate within 4 weeks with one patient showing no improvement in symptoms even after 8 weeks. There were no adverse events associated with the procedure nor technical issues with the product. The product is easy to learn and use. Further study is needed to draw any conclusions on long term safety and efficacy, though historical records and preliminary results for this procedure described in this paper seem promising.

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Long-term impact of behavioral weight loss intervention on cognitive function.

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Trans-tympanic Cartilage Chip Insertion for Intractable Patulous Eustachian Tube.

Project description:Background and objectivesPatulous Eustachian tube (PET) causes troublesome autophony. We treated PET using tragal cartilage chip insertion to fill in the concavity within the tubal valve and evaluated the feasibility of this method.Subjects and methodsThis study used a prospective design. Eleven patients with PET disorder were included. Tragal cartilage chip insertion via a transcanal approach into the Eustachian tube (ET) was performed in 14 ears of those patients. They were followed-up for at least 12 months after surgery and were evaluated by symptom questionnaire scores.ResultsThe average follow-up was 16.4 months. Thirteen of fourteen ears received immediate complete relief of autophony symptoms. Autophony symptoms at the last follow-up were as follows: four ears (28.6%) had complete relief; five ears (35.7%) showed satisfactory improvement; four ears (28.6%) showed significant but unsatisfactory improvement; and one ear (7.1%) was unchanged. The PET symptom questionnaire in the affected ears showed a significant reduction in autophony (p=0.047) and improvement in breathing sound conduction (p=0.047). There were no complications such as otitis media or occlusion symptom.ConclusionsTranstympanic cartilage chip insertion into the ET provides a safe and accessible surgical option for the treatment of PET.

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