Pressure chamber tests of eustachian tube function document lower efficiency in adults with colds when compared to without colds.

CONCLUSIONS: Fractional gradient equilibrated (FGE) for ears with applied positive but not negative middle ear (ME)-ambient pressure gradients is highly sensitive to a cold-like illness (CLI). OBJECTIVE: The sequential development of eustachian tube (ET) dysfunction, ME under-pressure, and otitis media (OM) characterizes many children during a CLI. If linked, OM burden would be lessened by interventions that promote/preserve good ET function during a CLI. Evaluating this requires a quantitative ET function test for MEs with an intact tympanic membrane responsive to a CLI. METHODS: Pressure chamber testing of ET function was performed at +200 and -200 daPa in 3 groups of adults: group I, 21 subjects with an extant CLI and groups II and III, 14 and 57 adults, respectively, without a CLI. ME-chamber pressure gradient was recorded by tympanometry before and after the subject swallowed twice. ET functional efficiency was quantified as the FGE, which was then compared among groups using a Mann-Whitney U test. RESULTS: At chamber pressures of 200 daPa, the ME-chamber pressure gradient was negative, and FGE was low and not different among groups. At chamber pressures of -200 daPa that gradient was positive, and FGE was significantly higher in groups II and III when compared with group I.

Relationship between the electromyographic activity of the paratubal muscles and eustachian tube opening assessed by sonotubometry and videoendoscopy.

OBJECTIVE: To determine the role played by the tensor veli palatini and levator veli palatini muscles (mTVP and mLVP, respectively) in eustachian tube (ET) opening. DESIGN: Prospective study. SETTING: Research laboratories at a tertiary care hospital. PATIENTS: Fifteen healthy adults with normal middle ears and documented ET openings. INTERVENTIONS: Submental and ground surface electrodes were placed. After anesthetizing and decongesting the nasal passages, paired electromyographic needle electrodes were inserted into both the mTVP and mLVP on the test side. A microphone was placed into the ipsilateral ear canal and the probe from a sound generator was introduced into the opposite nostril. A 45° telescope was used on the test side to video-record the soft palate and ET movements while the individual swallowed. MAIN OUTCOME MEASURES: Concurrent recordings of the ET openings by sonotubometry, the electromyographic activity for the LVP, TVP, and submental muscles, and video of the nasopharyngeal orifice of the ET during swallowing. RESULTS: During swallowing, the median peak amplitude and duration of ET openings by sonotubometry were 30.6 mV and 196 milliseconds, respectively. For the mLVP and mTVP, the median peak amplitudes were 0.33 and 0.82 mV, and peak durations were 131 and 85 milliseconds, respectively. The mean onsets of muscle activity referenced to the sonotubometry peak amplitude were -0.28, -0.24, and -0.14 milliseconds for the mLVP, mTVP, and submental muscles, respectively. Video recording of ET movements were consistent with the timing of these events. CONCLUSIONS: The mTVP activity had a shorter duration but greater amplitude than the mLVP activity and was associated with peak ET opening by sonotubometry. The mLVP activity occurred before that of the mTVP, the submental muscle group, and peak ET opening. The mLVP contractions were associated with movements of the soft palate, anterior ET orifice, and rotation of the ET cartilage.

Assessment of deafmute patients: a study of ten years.

Present prospective study was conducted on 350 patients presenting with chief complaints of impaired hearing and delayed speech from 1996-2006. The aim of the present study was to find out the prevalence of deafmutism in our area, the aetiology of childhood deafness and to ascertain the role of acoustic reflex test (ART) for hearing screening considering brain stem evoked response audiometry (BSERA) as gold standard. A detailed history, clinical and other relevant systemic examination and investigations were done to find out the cause. All patients were subjected to ART test and BSERA. Male to female ratio was 2.1:1. Prevalence was found to be 5.59 per one lac population in our district. The commonest age of presentation was in the second decade. The causes for childhood deafness were genetic (15.8%), embryopathies (10%), perinatal (10.8%) and postnatal problems (12.5%). In 50.6% cases it was aediopathic. Congenital syndromic abnormalities were found in 5.4% patients. In BSERA 21% patients were found to have residual hearing varying from 60 dB to 100dB. The positive predictive value of ART was found to be low (10.4%). Hence it was recommended that ART should not be used as screening tool for childhood deafness.

Our experiences with parapharyngeal space tumors and systematic review of the literature.

OBJECTIVES: To find out the geographical distribution, age, sex, mode of presentation, diagnostic modalities, surgical approaches, postoperative complications, follow-up and histopathology of parapharyngeal space tumors (PFT) through world wide web search (WWWS) and PFT of our series. MATERIALS AND METHODS: A retrospective study of all PFT seen and treated in S.R.N Hospital, Allahabad between 1990 and 2006 was done. A systematic review of the literature was done through WWWS. RESULTS: PFT were commonest in the Asian zone. Incidence was highest in the 3rd and 4th decade. Oropharyngeal (100%) and cervical (91.6%) swelling were the commonest presentation. MRI is better than CT scan in evaluating fat plane. Transcervical approach was the commonest. In our series, benign tumors (83.4%) were common, constituting 50% of neurogenic and 16.6% of salivary gland origin. CONCLUSION: PFT were more prevalent in the Asian zone. Neurogenic tumors were commonest in our study which contradicts the WWWS of having maximum PFT of salivary gland in origin.

Effects of radiotherapy on parotid salivary sialochemistry in head and neck cancer patients.

AIM: To determine the effects of high dose irradiation on parotid salivary sodium and pH concentration at subsequent duration of 1.5, 3 and 6 months following radiotherapy. MATERIALS AND METHODS: Eighty parotid glands of head and neck cancer patients were irradiated with mean dose of 66 Gy. The stimulated parotid flow (PF) was collected by a cannulation of Stenson's duct followed by analysis of sodium (PF sodium) by Easylyte Sodium/Potassium auto analyzer and pH by litmus narrow band pH paper. RESULTS: A steep elevation of PF sodium was found in post-RT period after 1.5 months of starting RT followed by gradual increase up to 6 months and pH changed towards acidity. CONCLUSIONS: A high dose of 66 Gy causes irreversible damage to parotid salivary duct system.