- Effects of acidic and nonacidic reflux on the eustachian tube: An animal experiment. [Journal Article]
- ENEar Nose Throat J 2018; 97(12):E21-E27
- We investigated the effects of pepsin/hydrochloric acid and bile acids on eustachian tube function and eustachian tube mucosa in 40 Sprague-Dawley rats. The animals were randomly assigned to groups o...
We investigated the effects of pepsin/hydrochloric acid and bile acids on eustachian tube function and eustachian tube mucosa in 40 Sprague-Dawley rats. The animals were randomly assigned to groups of 10: one group received pepsin/hydrochloric acid (pepsin/HCl group), another received human bile (human bile group), a third received a mixture of pepsin/HCl and human bile (combination group), and the fourth received isotonic saline solution (control group). Test solutions were applied transnasally three times a day for 10 days. Passive opening pressures and passive closing pressures were measured digitally at baseline and then on days 3, 5, and 10. After 10 days, the rats were sacrificed and histologic changes in the eustachian tube mucosa were analyzed. At study's end, we observed that the increases in passive opening pressures and passive closing pressures in all three experimental groups were significantly greater than those of the control group. Moreover, the increases in passive opening and closing pressures were significantly greater in the combination group than in both the pepsin/HCl and the human bile groups. In the tympanic orifice, the degree of lymphocyte and polymorphonuclear leukocyte infiltration was significantly higher in all three experimental groups than in the control group. In the nasopharyngeal orifice, lymphoid follicle formation was significantly more common in the human bile group than in the control group; also, the presence of subepithelial vasodilation and subepithelial edema was significantly more common in the pepsin/HCl and combination groups than in the controls. Of the three experimental solutions tested, the combination of pepsin/HCl and human bile was the most injurious to eustachian tube function. Reflux of bile acids causes eustachian tube dysfunction, and this damage worsens with the introduction of an acidic compound.
- Eustachian Tube dysfunction in chronic rhinosinusitis: pre and post-operative results following endoscopic sinus surgery, a prospective study. [Journal Article]
- RRhinology 2018 Dec 11
- CONCLUSIONS: We found a high incidence of concurrent ETD symptoms in patients with severe CRS, which improve following ESS. Further research is required to better understand the association between CRS and ETD in order to provide effective treatments.
- Cofactors of Pediatric Tinnitus: A Look at the Whole Picture. [Journal Article]
- CPedClin Pediatr (Phila) 2018 Dec 03; :9922818816426
- Retrospective chart review of 248 children (1-19 years old) with tinnitus who presented to a tertiary pediatric hospital between 2006 and 2011, looking at which cofactors are predictors of pediatric ...
Retrospective chart review of 248 children (1-19 years old) with tinnitus who presented to a tertiary pediatric hospital between 2006 and 2011, looking at which cofactors are predictors of pediatric tinnitus. In our review, we extracted demographics, symptoms, historical data, imaging, and laboratory results; we compared with the general population. Eighty-seven percent had normal hearing. Age distribution, noise exposure, and frequency of psychiatric diagnoses in our cohort were consistent with previous reports. We found a lower incidence of otitis media and the same prevalence of dizziness, asthma, and hearing loss as the general population, a lower prevalence of Eustachian tube dysfunction, otitis media, headaches, and higher incidence of rhinosinusitis. Lack of patient reporting and objective testing complicate the ability to detect pediatric tinnitus. We revealed a gap in the literature regarding rhinosinusitis as a cofactor, imaging during diagnosis, and if psychiatric diagnoses are associated with tinnitus in younger children.
- A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations. [Journal Article]
- AOAnn Otol Rhinol Laryngol 2018 Nov 28; :3489418815517
- CONCLUSIONS: GPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.
- Presentation and eustachian tube function test results in children evaluated at a specialty clinic. [Journal Article]
- LLaryngoscope 2018 Nov 25
- CONCLUSIONS: ETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing.
- Eustachian Tube Dysfunction and Wideband Absorbance Measurements at Tympanometric Peak Pressure and 0 daPa. [Journal Article]
- JAJ Am Acad Audiol 2018 Nov 14
- CONCLUSIONS: Hence, a comparison of WBA₀ and WBATPP can provide potentially useful diagnostic information, and hence can be used as an adjunct tool to evaluate ETD. This is important especially in young children or some adults who are unable to perform maneuvers such as Toynbee or Valsalva during ETD assessment. Further research is needed to verify the results using test performance measures to determine whether WBA₀ and WBATPP can objectively determine the presence of ETD or OME with NMEP.
- Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. [Journal Article]
- PlosPLoS One 2018; 13(11):e0206946
- CONCLUSIONS: ETD should be diagnosed on the basis of clinical assessment and tests of ET opening, as PROMs have no diagnostic value. Currently diagnostic uncertainty exists for some patients who appear to have intermittent ETD clinically, but have negative index test results.
- The pharyngeal recess/Eustachian tube complex forms an acoustic passageway. [Journal Article]
- MHMed Hypotheses 2018; 121:112-122
- We propose that the complex formed by the Pharyngeal Recess and Eustachian Tube, acts as an acoustic passageway for sounds originating inside the body: sounds made by one's voice, breathing, masticat...
We propose that the complex formed by the Pharyngeal Recess and Eustachian Tube, acts as an acoustic passageway for sounds originating inside the body: sounds made by one's voice, breathing, mastication, one's heartbeats. The antagonistic effect of two sets of muscles, one innervated by the trigeminal nerve, the other by the vagal nerve and cervical plexus, enables the body to modulate transmission of sound via this passageway and hence modulate the awareness of body sounds. Impairment of this system can be due to local factors, such as adhesions over the pharyngeal recess or inflammation inside the pharyngeal recess and/or Eustachian tube; or to tensions of the muscles involved, related to other causes. Dysfunction of the system can lead to symptoms related to increased or decreased awareness of body sounds, such as autophony, hearing of pulsating sounds and clicks in the ear; sensory symptoms related to increased activation of the nerves such as fullness feeling in the ear, facial pain, burning mouth syndrome, globus pharyngeus, pharyngeal pain; and symptoms related to inappropriate muscular contraction such as masticatory and cervical muscle tensions, bruxism, and tension type headache. The functioning of this acoustic passageway is related to the concept of the Trigeminocervical complex. The concept of Vagocervical complex is proposed.
- Association between symptomatic submucous cleft palate and otologic disease: A retrospective review. [Journal Article]
- IJInt J Pediatr Otorhinolaryngol 2018; 115:77-81
- CONCLUSIONS: Patients with symptomatic SMCP suffer from a higher incidence of otologic disease and bilateral myringotomy tube placement than the general population. This is an important potential comorbidity in SSMCP patients as it can act as a further barrier to speech acquisition. Further research is needed to determine if otologic disease can be used for prognostication or treatment purposes.
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- Cleft lip and palate associated hearing loss in Brazilian children. [Journal Article]
- IJInt J Pediatr Otorhinolaryngol 2018; 115:38-40
- CONCLUSIONS: The worst hearing thresholds were found in children of 4-7 years old: 21.2 dB MHT 500-4 KHz and 19.7 ABG 500-4 KHz, what is a disadvantage for them, as the normal hearing thresholds are up to 15 dB. The children of 8-14 years old had MHT 500-4 KHz of 17.5 dB, and ABG 500-4KHZ OF 13.2 with up to 70 dB of hearing loss.