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2.
Artigo em Chinês | MEDLINE | ID: mdl-35527436

RESUMO

Objective: To establish a three-dimensional model of middle ear-eustachian tube based on Chinese digital visual human dataset, and the deformation and pressure changes of the middle ear-eustachian tube system after eustachian tube opening are simulated by computer numerical simulation. Methods: The first female Chinese Digital Visual Human data was adopted. The images were imported by Amira image processing software, and the images were segmented by Geomagic software to form a three-dimensional model of middle ear-eustachian tube system, including eustachian tube, tympanum, tympanic membrane, auditory ossicles, and mastoid air cells system. The 3D model was imported into Hypermesh software for meshing and analysis. The structural mechanics calculation was carried out by Abaqus, and gas flow was simulated by Xflow. The tissue deformation and middle ear pressure changes during eustachian tube opening were numerically simulated by fluid-solid coupling algorithm. Several pressure monitoring points including tympanum, mastoid, tympanic isthmus, and external auditory canal were set up in the model, and the pressure changes of each monitoring point were recorded and compared. Results: In this study, a three-dimensional model of middle ear-eustachian tube and a numerical simulation model of middle ear ventilation were established, including eustachian tube, tympanum, mastoid air cells, tympanic membrane, and auditory ossicles. The dynamic changes of the model after ventilation could be divided into five stages according to the pressure. In addition, the pressure changes of tympanum and tympanic isthmus were basically synchronous, and the pressure changes of mastoid air cells system were later than that of tympanum and tympanic isthmus, which verified the pressure buffering effect of mastoid. The extracted pressure curve of the external auditory canal was basically consistent with that of tympanometry in terms of value and trend, which verified the effectiveness of the model. Conclusions: The numerical simulation model of middle ear-eustachian tube ventilation established in this paper can simulate the tissue deformation and middle ear pressure changes after eustachian tube opening, and its accuracy and effectiveness are also verified. This not only lays a foundation for further research, but also provides a new research method for the study of middle ear ventilation.


Assuntos
Tuba Auditiva , China , Orelha Média , Feminino , Corpo Humano , Humanos , Ventilação da Orelha Média
4.
Int J Pediatr Otorhinolaryngol ; 156: 111070, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35228098

RESUMO

OBJECTIVE: Eustachian tube dysfunction is believed to be involved in the pathogenesis of many middle ear diseases including chronic suppurative otitis media. We aimed to describe a simple and reliable animal model of Eustachian Tube obstruction to further research into middle ear disorders. STUDY DESIGN: Prospective cohort study in animals. SETTING: University laboratory. SUBJECTS AND METHODS: 30 mice C57Bl/6J (n = 15) and CBA/CaJ (n = 15) aged 6-8 weeks received transtympanic Eustachian tube occlusion on left ear trough an acute tympanic membrane perforation using thermoplastic latex used in dental procedures (gutta percha). Control mice (n = 6) received tympanic membrane perforation only. At two and four weeks, the mice were observed for signs of Eustachian tube dysfunction and compared to control ears. ET dysfunction was defined as presence of effusion in the middle ear. RESULTS: 100% (n = 30) of the treated ears had otoscopic signs of Eustachian tube dysfunction at two weeks and the endpoint time of four weeks, compared to 0% in control mice (0/6). Temporary head tilt lasting up to 2 days were observed in 3 mice (10%). No other potential adverse events were recorded. No bacterial growth was determined in the middle ear fluid. CONCLUSION: We describe a technically easy and reliable method for Eustachian tube occlusion in mice with an excellent success rate and minimal morbidity.


Assuntos
Tuba Auditiva , Otite Média com Derrame , Otite Média Supurativa , Otite Média , Perfuração da Membrana Timpânica , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Camundongos Endogâmicos CBA , Otite Média/complicações , Otite Média com Derrame/complicações , Otite Média Supurativa/complicações , Estudos Prospectivos , Perfuração da Membrana Timpânica/cirurgia
5.
Sci Rep ; 12(1): 3436, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35236923

RESUMO

Various preclinical studies with developed Eustachian tube (ET) stents are in progress but have not yet been clinically applied. ET stent is limited by stent-induced tissue hyperplasia in preclinical studies. The effectiveness of sirolimus-eluting cobalt-chrome alloy stent (SES) in suppressing stent-induced tissue hyperplasia after stent placement in the porcine ET model was investigated. Six pigs were divided into two groups (i.e., the control and the SES groups) with three pigs for each group. The control group received an uncoated cobalt-chrome alloy stent (n = 6), and the SES group received a sirolimus-eluting cobalt-chrome alloy stent (n = 6). All groups were sacrificed 4 weeks after stent placement. Stent placement was successful in all ETs without procedure-related complications. None of the stents was able to keep its round shape as original, and mucus accumulation was observed inside and around the stent in both groups. On histologic analysis, the tissue hyperplasia area and the thickness of submucosal fibrosis were significantly lower in the SES group than in the control group. SES seems to be effective in suppressing stent-induced tissue hyperplasia in porcine ET. However, further investigation was required to verify the optimal stent materials and antiproliferative drugs.


Assuntos
Stents Farmacológicos , Tuba Auditiva , Animais , Ligas de Cromo , Cobalto , Stents Farmacológicos/efeitos adversos , Tuba Auditiva/efeitos dos fármacos , Tuba Auditiva/patologia , Tuba Auditiva/cirurgia , Hiperplasia/patologia , Hiperplasia/prevenção & controle , Sirolimo/farmacologia , Stents/efeitos adversos , Suínos , Resultado do Tratamento
6.
Otol Neurotol ; 43(4): e442-e445, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35120077

RESUMO

OBJECTIVES: To describe cases of patulous Eustachian tube (PET) or patent ET conditions in oculopharyngeal muscular dystrophy (OPMD). PATIENTS: Four cases of PET or patent ET conditions with OPMD. MAIN OUTCOME MEASURES: Clinical case records, objective ET function tests (tubo-tympano-aerodynamic graphy and sonotubometry), and swallowing function (videoendoscopic examination and Food Intake Level Scale) were analyzed. RESULTS: Two cases of definite PET, one case of possible PET, and one case lacking aural symptoms with findings of patent ET. All patients have ptosis, and three cases have dysphagia. Body mass index indicated that three cases were underweight. Magnetic resonance imaging in case 4 showed atrophy and fat replacement of palatine and masticatory muscles. CONCLUSIONS: It is important to consider PET or patent ET conditions when OPMD patients describe aural symptoms.


Assuntos
Otopatias , Tuba Auditiva , Distrofia Muscular Oculofaríngea , Otite Média , Otopatias/patologia , Humanos , Distrofia Muscular Oculofaríngea/complicações , Distrofia Muscular Oculofaríngea/patologia , Otite Média/patologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-35190086

RESUMO

INTRODUCTION: The influence of isolated nasal septum deviation (NSD) in the Eustachian Tube (ET) function is still undetermined. OBJECTIVE: compare ET function between patients with severe NSD and patients with adequate nasal patency in terms of symptomology and objective exams and assess the impact of septoplasty in ET function in patients with severe NSD. METHODS AND METHODOLOGY: a prospective study was conducted. In the first phase of the study, two opportunistic samples were selected: 35 patients with severe NSD for group A and 35 patients with adequate nasal patency for group B. Both groups were evaluated through Nasal obstruction Subjective Questionnaire (NOSE) and ET dysfunction questionnaire 7 (ETDQ7) -, and through two objective exams to assess ET function - tympanometry, and tubomanometry (TMM); results were compared between group A and B. In the second phase of the study, the patients from group A underwent septoplasty and were re-evaluated through ETDQ7, tympanometry and TMM; results were compared before and after surgery. RESULTS: we found a statistically significant difference between patients with NSD and patients with adequate nasal patency in NOSE and ETDQ7 (higher scores in the latter), and TMM (worse results in patients with NSD); the difference in tympanometry was not statistically significant. The side of the NSD did not correlate with the side of the dysfunction. After septoplasty, patients from group A had statistically significant lower scores in ETDQ7 and a lower proportion of patients with findings compatible with ET dysfunction using TMM. CONCLUSION: according to our results, severe NSD alone is a cause of ET dysfunction; septal surgery might improve ET function in these patients.


Assuntos
Testes de Impedância Acústica , Tuba Auditiva , Testes de Impedância Acústica/métodos , Estudos de Casos e Controles , Humanos , Septo Nasal/cirurgia , Estudos Prospectivos
8.
Otol Neurotol ; 43(4): e446-e453, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35085108

RESUMO

OBJECTIVE: To evaluate the Eustachian tube (ET) dimensions in patulous ET (PET) patients compared with that by aging using sitting 3D computed tomography (CT). STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center. SUBJECTS AND METHODS: A retrospective survey of medical records in Sen-En Rifu Hospital identified 105 ears of 76 PET patients and 65 ears of 34 patients without ET dysfunction findings (non-PET). Subjects in both PET and non-PET groups were then divided into two age groups. Groups A and C defined as non-PET and PET subjects respectively, who were under the age of 60 years, while Groups B and D defined of non-PET and PET subjects respectively, who were 60 years and above. 3D CT (Accuitomo; Morita, Kyoto, Japan) was performed on all subjects in the sitting position. The ET lumen from the ET pharyngeal orifice to 15 mm was analyzed. RESULTS: No significant difference in the ET lumen near the pharyngeal orifice was found between Group A and C; however, there was a significant difference in the ET at points lateral to the pharyngeal orifice. The ET lumen was significantly larger at the site close to the pharyngeal orifice in Group B as compared to that of Group A. For the two groups of PET classified according to the size of the pharyngeal orifice and area close to the isthmus, age was only significantly different between two groups of pharyngeal orifice. On the contrary, sonotumometry and Ohta method were significantly different between the two groups of the area close to the isthmus. CONCLUSION: The lumen of the ET is enlarged in both PET and aging. However, the responsible site was found to be different. While the enlargement of the ET lumen in 60 years and above subjects without PET mainly occurred near the pharyngeal orifice of the ET, it was near the isthmus in under 60 years PET patients. Further study of possible clinical implications of these findings as well as treatment strategy are required.


Assuntos
Otopatias , Tuba Auditiva , Otite Média , Envelhecimento , Otopatias/diagnóstico por imagem , Tuba Auditiva/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
Niger J Clin Pract ; 25(1): 55-61, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35046196

RESUMO

BACKGROUND: The posterior wall of the nasopharynx is composed of loose connective tissue that includes many important anatomical structures. Various structures, such as the opening of the Eustachian tube (ET), the Rosenmüller fossa (RF), and the pharyngeal bursa (PB) are found here. AIM: To evaluate the nasopharynx posterior wall anatomic structures, including the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa with cone-beam computed tomography. MATERIALS AND METHODS: The depth, width, and length of the Eustachian tube, Rosenmüller fossa, and pharyngeal bursa were measured in 150 patients using axial-sagittal cone-beam computed tomography. The Eustachian tube and Rosenmüller fossa distance to the midsagittal plane, the coronal region passing through the posterior end of the nasal septum, the superior-inferior extremity of the recesses, and the nasal floor plane distance were measured. The relationship between Rosenmüller fossa types and other parameters were evaluated. RESULTS: The incidence of right Rosenmüller fossa types 1, 2, and 3 were 16%, 18%, and 66%, respectively, and that of the left Rosenmüller fossa types 1, 2, and 3 were 16%, 19.3%, and 64.7%, respectively. The mean pharyngeal bursa width, length, and depth were 10.8, 5.7, and 4.0 mm, respectively; those of the Eustachian tube were 5.6, 7.1, and 7.3 m, respectively; those of the right Rosenmüller fossa were 4.0, 12.4, and 10.5 mm, respectively; and those of the left Rosenmüller fossa were 3.8, 12.5, and 10.9 mm, respectively. CONCLUSIONS: The posterior wall of the nasopharynx contains several important anatomical structures. Evaluation of these using cone-beam computed tomography has many clinical and radiological advantages. To understand and interpret the coincidental findings in CBCT, dental radiologists should have access to more detailed information concerning the anatomy of the nasopharynx.


Assuntos
Tuba Auditiva , Nasofaringe , Tomografia Computadorizada de Feixe Cônico , Tuba Auditiva/diagnóstico por imagem , Humanos , Nasofaringe/diagnóstico por imagem
10.
Int J Pediatr Otorhinolaryngol ; 154: 111048, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35085875

RESUMO

OBJECTIVES: Eustachian tube dysfunction is a common condition that may lead to otitis media with effusion, hearing loss and developmental delays in children. We sought to determine the efficacy and safety of balloon dilation of the eustachian tube (BDET) in the pediatric population. DATA SOURCES: Original studies of BDET in a pediatric population were identified in PubMed, Embase, Web of Science, Cochrane, Clinicaltrials.gov and CINAHL. METHODS: Outcomes of efficacy included audiometric findings and adverse events were summarized for each study. RESULTS: Seven articles were included involving 408 children with a mean age of 9.9 years old (95%CI 8.8, 11.1) and a mean follow up of 19.2 months (95%CI 15, 23). Type B tympanograms decreased after BDET from 64.2% (95%CI 53.3, 73.8) to 16.1% (95%CI 8.5, 28.4). Air-bone gap (ABG) decreased after BDET from a mean of 25.3 dB (95%CI 18.9, 31.6) to 10.2 dB (95%CI 8.9, 11.5). The pooled estimate of adverse events after BDET was 5.1% (95%CI 3.2, 8.1), the majority being self-limited epistaxis with no major adverse events reported. Three studies compared BDET to ventilation tube insertion; analysis of post-operative ABG showed a greater decrease in the BDET group (mean difference -6.4 dB; 95%CI -9.8, -3.1; p = 0.002). CONCLUSION: Although there are no prospective randomized control trials, BDET ± tympanostomy tube placement may produce outcomes that are comparable to tympanostomy tube placement in the treatment of otitis media with effusion in the pediatric population. Most children undergoing the procedure are those with recalcitrant disease. The procedure is safe with the most common complication being epistaxis.


Assuntos
Otopatias , Tuba Auditiva , Otite Média com Derrame , Cateterismo , Criança , Dilatação , Otopatias/cirurgia , Tuba Auditiva/cirurgia , Humanos , Ventilação da Orelha Média , Otite Média com Derrame/cirurgia
11.
Artigo em Chinês | MEDLINE | ID: mdl-34979614

RESUMO

Objective:To evaluate the Eustachian tube function of children with simple adenoid hypertrophy and adenoid hypertrophy with secretory otitis media(OME) by using the A/N value of lateral radiograph of nasopharyngeal X-ray and EDQ-7 scale scores. Methods:Sixty cases of children with adenoid hypertrophy admitted from February 2019 to August 2021 were all underwent nasopharyngeal X-ray lateral radiographs to determine the adenoid/nasopharyngeal cavity ratio(A/N ratio) and then determine the size of adenoids. The Eustachian tube function ETDQ-7 survey was used to evaluate the patient's self-evaluation of the severity of the disease and ear symptoms, and the degree of influence were scored. Subsequently, the correlation between adenoid hypertrophy with OME and ETDQ-7 scores was statistically analyzed by using the Spearman rank correlation statistical method. Results:In adenoid hypertrophy with OME group, the ETDQ-7 scores of A/N≤0.60, A/N 0.61-0.70 and A/N≥0.71 were 4.15±1.75, 14.55±6.67 and 23.95±6.63, respectively. The higher the grade of adenoid hypertrophy, the higher the ETDQ-7 scores. In adenoid hypertrophy with OME group, the degree of adenoid hypertrophy was positively correlated with the ETDQ-7 scores(P<0.05). Conclusion:Adenoid hypertrophy is also one of the potential factors causing OME in children.


Assuntos
Tonsila Faríngea , Tuba Auditiva , Otite Média com Derrame , Tonsila Faríngea/diagnóstico por imagem , Criança , Tuba Auditiva/diagnóstico por imagem , Humanos , Hipertrofia , Fotografação
12.
Auris Nasus Larynx ; 49(3): 352-359, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34593272

RESUMO

OBJECTIVE: Investigate radiological findings on temporal bone computed tomography, which are associated with obstructive Eustachian tube dysfunction and determine its diagnostic validity. METHODS: The present study was conducted as a prospective, cross-sectional case series study in a tertiary referral center. Forty patients with clinically diagnosed unilateral Eustachian tube dysfunction and older than 16 years old underwent pre interventional radiological assessment by temporal bone computed tomography while performing a Valsalva-maneuvre to enhance visualization of Eustachian tube lumen. The Eustachian tubes were assessed for intersite morphological differences, presence of mucus in the lumen or middle ear cleft and secretion retention or mucosal swelling in the adjacent sinuses. Image analyses and radiological statements about the side of pathology were delivered blinded to the clinical diagnoses. RESULTS: The radiologic detection of mucus/mucosal edema in Eustachian tube or adjacent middle ear cleft structures was associated with the pathological side (t (1, N = 40) = 3.60, p = 0.001 < 0.05). On the contrary, there is no association between radiological findings of sinonasal disease and side of Eustachian tube dysfunction (x2 (1, N = 40) = .00, p = 1.00 > 0.05). The diagnostic value of radiologic assessment in Eustachian tube dysfunction has a sensitivity and specificity of 52,5 and 97,5% respectively. CONCLUSION: The sensitivity of radiologic assessment is rather low, and hence it is inappropriate as a screening tool for Eustachian tube dysfunction in routine clinical practice. In the case of present CT-scans of the temporal bone, the focus should be laid on the detection of mucus in the Eustachian tube or adjacent structures, as a predictor of disease.


Assuntos
Otopatias , Tuba Auditiva , Adolescente , Estudos Transversais , Tuba Auditiva/diagnóstico por imagem , Humanos , Estudos Prospectivos , Tomografia Computadorizada por Raios X
13.
Eur Arch Otorhinolaryngol ; 279(5): 2223-2230, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34590179

RESUMO

PURPOSE: Tubomanometry (TMM) and the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) was integrated to establish the Tubomanometry Eustachian Tube Dysfunction Questionnaire (T-ETDQ), and its reliability, potential clinical application, and diagnostic value for Eustachian tube function were investigated. METHODS: This prospective diagnostic study included patients visiting the ENT Department of our Hospital, between April and June 2021. Patients were grouped into Eustachian tube dysfunction (ETD) and control groups according to tympanometry diagnosis results. The diagnostic value of the T-ETDQ was evaluated using receiver-operating characteristic (ROC) curve analysis. RESULTS: There were 48 patients with Obstructive ETD and 24 patients without. The area under the ROC curve (AUC) of T-ETDQ was 0.898 (95% confidence interval [CI] 0.826-0.969), and the highest sensitivity and specificity were 76.7% and 86.7% respectively when the positive cutoff value was 4.72. The AUC of Eustachian tube score (ETS) was 0.731 (95% CI 0.625-0.837) and the highest sensitivity and specificity were 48.3% and 90.0% respectively when the positive cut-off value was 4.5. The ETS and T-ETDQ had kappa values of 0.311 and 0.585, respectively (P < 0.001 for both), showing both methods were comparable to tympanometry; however, T-ETDQ had more consistent results than ETS. CONCLUSION: T-ETDQ can effectively quantify and evaluate ETD severity in adults, has a higher diagnostic value than ETS, making it a suitable diagnostic tool.


Assuntos
Otopatias , Tuba Auditiva , Testes de Impedância Acústica , Adulto , Otopatias/diagnóstico , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes
14.
Otol Neurotol ; 43(2): 206-211, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34669684

RESUMO

OBJECTIVE: Demonstrate the ability of a novel steerable distal chip endoscope to traverse the Eustachian tube and provide diagnostic quality images of the human middle ear. PATIENTS: Three cadaveric temporal bone specimens were used in this work. INTERVENTION: Diagnostic transeustachian endoscopy of the middle ear was performed. MAIN OUTCOME MEASURE: Diagnostic image quality. RESULTS: A novel 1.62 mm steerable endoscope successfully cannulated the Eustachian tube of three human cadaveric temporal bone specimens to reveal intact middle ear anatomy with high optical clarity. CONCLUSIONS: A steerable endoscope can be designed to traverse the human Eustachian tube and provide diagnostic quality images of middle ear anatomy.


Assuntos
Orelha Média , Tuba Auditiva , Cadáver , Orelha Média/anatomia & histologia , Orelha Média/diagnóstico por imagem , Orelha Média/cirurgia , Endoscópios , Endoscopia/métodos , Tuba Auditiva/diagnóstico por imagem , Tuba Auditiva/cirurgia , Humanos
15.
Laryngoscope ; 132(4): 849-856, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34606099

RESUMO

OBJECTIVE: Medical treatment for eustachian tube dysfunction (ETD) is varied, with physician preference driving treatment choice and limited guidance for these options. An evaluation of the efficacy of medical management (MM) for ETD is warranted. METHODS: A systematic review of three databases (PubMed, Scopus, and Embase) was performed through December 2020. Adults treated nonsurgically for ETD were included. Exclusion criteria were as follows: patulous ETD, ETD deriving from craniofacial anomalies, or surgical treatment. Data were extracted independently by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis of continuous measures, proportions, and risk ratio was conducted. RESULTS: Twelve articles were identified by systematic review, with either level 2 or 3 evidence. A meta-analysis of available data was performed on nine studies. A pooled cohort found 50.3% (95% confidence interval [CI], 41.7-59.0) of patients experienced symptomatic improvement with MM. ETDQ-7 scores improved in a clinically nonsignificant manner by -0.88 (95% CI, -1.12 to -0.64) following medical treatment. Further, MM benefited from subacute and chronic symptoms in 30% to 64% and 11% to 50% of cases, respectively. Intranasal corticosteroids (INCS) were not efficacious, improving only 11% to 18% of chronic cases. Therapies such as Politzer devices and Valsalva therapy had minimally beneficial results. CONCLUSION: Our review did not find any level 1 evidence for MM of ETD in adults. Available evidence indicates INCS are ineffective for chronic symptoms and the efficacy of nonsurgical options for subacute ETD has yet to be determined. Further randomized controlled trials are needed to discern efficacy of single-agent medical therapies. Laryngoscope, 132:849-856, 2022.


Assuntos
Otopatias , Tuba Auditiva , Adulto , Otopatias/diagnóstico , Humanos
16.
Laryngoscope ; 132(3): 648-654, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34599608

RESUMO

OBJECTIVES: To evaluate histologic changes in middle ear and eustachian tube (ET) mucosa of mice after exposure to tobacco or electronic cigarette (e-cigarette) smoke. To determine whether there were any mitigating effects of middle ear application of anti-IL-13 or the epidermal growth factor receptor antagonist AG1478 on noted changes within ET mucosa. STUDY DESIGN: Controlled animal study. METHODS: Fifty BALB/cJ mice were randomly assigned to one of five groups: A control group with no smoke exposure, two groups exposed to tobacco smoke, and two groups exposed to e-cigarette vapor. Within the exposed groups after 4 weeks of exposure, one ear was infiltrated with a saline hydrogel and the other ear with hydrogel of either Anti-IL-13 or AG1478. After four more weeks of exposure, the animals were euthanized and the ETs were evaluated for mucosal changes. RESULTS: Compared to control animals with no smoke exposure, there were significant decreases in the numbers of goblet cells within the ET mucosa of mice exposed to tobacco smoke and e-cigarette vapor. No significant differences in cilia, mucin, or squamous metaplasia were noted. Neither anti-IL-13 nor AG178 significantly altered goblet cell count in the ET mucosa of mice exposed to tobacco smoke; however, both agents significantly increased goblet cells within the ET mucosa of mice exposed to e-cigarette vapor. CONCLUSION: Short-term tobacco smoke and e-cigarette vapor significantly decrease goblet cell count in mouse ET mucosa. Middle ear application of both anti-IL-13 and AG1478 resulted in an increase in goblet cell count among mice exposed to e-cigarette vapor, but not to tobacco smoke. LEVEL OF EVIDENCE: NA Laryngoscope, 132:648-654, 2022.


Assuntos
Vapor do Cigarro Eletrônico/efeitos adversos , Tuba Auditiva/efeitos dos fármacos , Membrana Mucosa/efeitos dos fármacos , Poluição por Fumaça de Tabaco/efeitos adversos , Animais , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Células Caliciformes/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C
17.
Otol Neurotol ; 43(2): 256-262, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34739430

RESUMO

BACKGROUND: Balloon dilation of the eustachian tube is a new therapeutic option for eustachian tube dysfunction. One of the limiting factors of wider adoption of this technique in many parts of the world is the high cost of the devices, in spite of regulatory approval of safety. OBJECTIVE: Evaluate the performance and usability of standard less-expensive endovascular balloons for eustachian tube dilation in comparison to an approved device in a preclinical study. STUDY DESIGN: Comparative cadaver feasibility study. SETTING: University tertiary care facility. METHODS: Ten eustachian tube dilations were performed with an approved eustachian tube dilation device. Ten other procedures were carried out with an endovascular balloon of similar dimensions. Cone beam computerized tomography was performed to evaluate the extent of dilation and possible damages. The lumen and mucosal lining were inspected endoscopically post-dilation. Volume measurements were compared before and after the procedure in both groups using contrast enhancement. RESULTS: All 20 eustachian tube dilations were carried out successfully. No tissue damages could be identified on cone-beam computerized tomography or via endoscopic examination. There was a statistically significant difference of eustachian tube volumes between pre- and post-dilations, with no statistically significant difference between the devices. CONCLUSION: Eustachian tube dilation with a less costly endovascular balloon achieved similar results to an approved eustachian tube dilation device. No damages or any other safety concerns were identified in a cadaver study.


Assuntos
Otopatias , Tuba Auditiva , Cadáver , Dilatação/métodos , Otopatias/cirurgia , Tuba Auditiva/cirurgia , Estudos de Viabilidade , Humanos
18.
Am J Rhinol Allergy ; 36(3): 297-306, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34796735

RESUMO

OBJECTIVES: The objective of this trial was to compare outcomes of electrocoagulation tuboplasty and continued medical therapy for treating persistent Eustachian tube dysfunction (ETD) with hypertrophic mucosa disease in the Eustachian tube (ET) orifice. STUDY DESIGN: Prospective, case-control trial. MATERIAL AND METHODS: Patients with persistent ETD were recruited and allocated to electrocoagulation tuboplasty and continued medical therapy groups. The ETD questionnaire-7 (ETDQ-7) score and objective parameters were compared between the groups at 6 and 12 months. RESULTS: The proportion of patients with a decrease in ETDQ-7 scores was greater in the electrocoagulation group than in the medical therapy group at the 6-month follow-up (53.49% and 34.38%, respectively; p = .158), but the difference was not statistically significant. However, at the 12-month follow-up, there was a significantly higher proportion of patients with a decrease in ETDQ-7 scores in the electrocoagulation group (88.37% and 40.63%, respectively; p = .001). Additionally, a significant difference was observed between the groups in terms of the proportion of patients who improved 12 months after the treatment (tympanometry: 72.09% and 9.38%, respectively; p = .001; air-bone gap: 79.07% and 25.00%, respectively; p = .001; tympanic membrane status: 62.79% and 0.00%, respectively). In addition, the proportion of patients with improvements in the ET inflammation score was significantly different between the groups at 6-month (67.44% and 34.38%, respectively; p = .009) and 12-month (93.02% and 34.38%; p = .001) follow-ups. No device- or procedure-related serious adverse events were reported in any patients. CONCLUSIONS: Electrocoagulation Eustachian tuboplasty appears to be a safe and feasible procedure for adult persistent ETD with hypertrophic mucosa disease in the ET orifice, and is superior to continued medical management alone. The improvements in ETDQ-7 and objective parameters persisted for 12 months.


Assuntos
Otopatias , Tuba Auditiva , Adulto , Otopatias/cirurgia , Eletrocoagulação , Tuba Auditiva/cirurgia , Humanos , Membrana Mucosa , Estudos Prospectivos
19.
Ear Nose Throat J ; 101(1): 15-19, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32543228

RESUMO

Pneumocephalus is usually induced by trauma, infections, tumors of the skull base, and surgical interventions. Spontaneous pneumocephalus occurs due to a defect in the temporal bone with no obvious cause. Few cases have been reported with spontaneous otogenic pneumocephalus. However, delayed postoperative pneumocephalus is rarely reported in the literature. Here, we present a case of otogenic pneumocephalus through Eustachian tube (ET) preceded by nose blowing 10 days after surgical treatment of meningoencephalocele of the right middle ear (ME) cleft and reconstruction of tegmen and dural defects. Pneumocephalus was provoked by decreased intracranial pressure (ICP) secondary to placement of lumbar drain, which caused direct communication between unsutured dural defect and the defective posterior wall of external auditory canal skin. A revision surgery of combined transmastoid/middle cranial fossa approach was performed for intracranial decompression followed by appropriate closure by suturing the dura, obliterating the ET and ME.


Assuntos
Orelha Média/cirurgia , Encefalocele/cirurgia , Otite Média Supurativa/cirurgia , Pneumocefalia/etiologia , Complicações Pós-Operatórias/etiologia , Osso Temporal/cirurgia , Tuba Auditiva , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/fisiologia , Reoperação , Osso Temporal/diagnóstico por imagem , Osso Temporal/patologia , Tomografia Computadorizada por Raios X
20.
Eur Arch Otorhinolaryngol ; 279(4): 1843-1850, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34095963

RESUMO

INTRODUCTION: The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Until now, there is insufficient literature about the pressure dynamics and Eustachian tube (ET) function during the Frenzel maneuver. The aim of the present study was to characterize the ET function during the Frenzel maneuver. MATERIALS AND METHODS: By means of an established standardized profile of compression and decompression in a hypo/hyperbaric pressure chamber, we examined different parameters such as the ET opening pressure (ETOP), ET opening duration (ETOD), and ET opening frequency (ETOF) in 11 experienced apnea divers and compared them to the parameters during the Valsalva and Toynbee maneuver. RESULTS: Standard values for ETOP, ETOD, and ETOF could be established for the Frenzel maneuver under standardized conditions in a hypo/hyperbaric pressure chamber. Compared to the Frenzel maneuver, ETOP was higher and ETOD longer (both p < 0.001) during the Valsalva maneuver whereas ETOP was lower and ETOD shorter (both p < 0.001) during the Toynbee maneuver. No difference regarding ETOF was observed between the Frenzel, Valsalva, and Toynbee maneuver. DISCUSSION: The Frenzel maneuver was shown to be at least as effective as the Valsalva maneuver concerning ET opening. We believe that knowledge of the Frenzel technique might facilitate the pressure equalization during diving and recommend implementation of an appropriate equalization training in apnea and scuba diving education.


Assuntos
Mergulho , Tuba Auditiva , Orelha Média , Humanos , Estudos Prospectivos , Manobra de Valsalva
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