Tubal function tests with optional myringotomy detect Eustachian tube closing failure in acquired pars flaccida retraction cholesteatoma

Publication date: February 2017
Source:Auris Nasus Larynx, Volume 44, Issue 1
Author(s): Phawana Asawapittayanont, Ryoukichi Ikeda, Hidetoshi Oshima, Toshiaki Kikuchi, Hiromitsu Miyazaki, Tetsuaki Kawase, Yukio Katori, Toshimitsu Kobayashi
ObjectiveTo re-evaluate the incidence of Eustachian tube closing failure in acquired middle ear cholesteatoma.MethodThirty-one cases with acquired middle ear cholesteatoma who received surgery were enrolled. Presence of Eustachian tube closing failure was determined through two Eustachian tube function tests. First Step Tests: Test 1: Positive sniff test identified by retraction of the tympanic membrane upon sniffing was observed. Test 2: The pressure in the external auditory meatus was found to change synchronously with that of the nasopharynx during respiration or upon sniffing. Second step test: For cases with negative First Step Tests, myringotomy was performed and Test 2 was repeated.ResultsTest 1 was positive in six (19.4%) and Test 2 was initially positive in nine (29.0%) out of 31 cases. Twelve out of 31 cases (38.7%) were positive for either one of the tests. The remaining 19 cases with initial negative test results subsequently received myringotomy and were subjected to Test 2 again. Positive results were obtained in five (13.9%) additional cases, and a final total of 17 (54.8%) out of 31 cases were positive for Eustachian tube closing failure.ConclusionSniff test with optional myringotomy may be useful for preoperative diagnosis of Eustachian tube closing failure.



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