| BACKGROUND: otitis media with effusion(OME)is a non-suppurative effusion in the middle ear,mainly manifested as a ear blocked and a hearing loss,but usually does not involve fever and obvious earache.It is argued that eustachian tube dysfunction may associated with the onset of OME,and nasal topical administration,including nasal hormones,nasal decongestants were used to treat OME,However,due to the lack of objective evaluation and test methods of Eustachian tube function,the relationship between eustachian tube dysfunction and OME not been confirmed,also,whether nasal topical administration of the medicine can really improve the function of the eustachian tube is not entirely clear.Recently,the eustachian tube manometer began to be used clinically,through this advice,a half objective evaluation of eustachian tube function,Both the association between eustachian tube dysfunction and OME,and the effect of nasal drops on the eustachian tube function in the patients of OME can be evaluated.OBJECTIVE: To investigate the function of eustachian tube in adult patients with OME by Eustachian tube manometer and eustachian tube score(ETS),and to explore the effect of nasal decongestants On the function of the Eustachian tube.METHODS: The criteria for the selection and diagnosis of OME was based on the past literature.Eighty patients with OME were examined by acoustic impedance test and manometry of the eustachian tube.The ETS was completed and then the patients were randomly divided into two groups equally.one group was treated with nasal saline and the other group with vasoconstrictor(0.05% oxymetazoline hydrochloride).After 30 minutes,the acoustic impedance test,manometry of the eustachian tube,and the the eustachian tube score was reevaluated.eustachian tube manometry was performed in three different pressure: 30 mbar,40mbar,and 50 mbar,the eustachian tube open index R was used to evaluated the function of eustachian tube function,R value ? 1 is normal,R value> 1 represent the delay pen of eustachian tube,and no recording of R represents the eustachian tube is completely blocked,the latter two are thought asabnormal opening of the eustachian tube.The eustachian tube function of The eustachian tube function was evaluated by observing the eustachian tube rating scale and abnormal opening rate,combined with the different tympanogram(type B or type C).RESULTS: Most of the patients with otitis media with effusion had eustachian tube dysfunction,on 30 mbar,40mbar and 50 mbar pressure,in the patients with tympanogram B,the proportion of abnormal opening of the eustachian tube was 78.26%,69.57% 60.87%,while in tympanogram C,the value were 71.08%,59.04% and 48.19%,respectively.Under all the different pressure conditions,there was no significant difference of this ratio in the patients with tympanogram B-type curve and tympanogram C-curve.The abnormal opening rate of eustachian tube in the saline group was 72.22%,59.26% and 50% respectively at 30 mbar,40mbar and 50 mbar,respectively.The rate of was changed to 64.81%,50 % and 37.04%,respectively(P = 0.407,0.334 and 0.174).Before administrating oxymetazoline hydrochloride,the abnormal opening rates of the eustachian tube were 73.08%,63.46% and 51.92%,respectively on the pressure with 30 mbar,40mbar and 50 mbar,and post rate was 69.23%,25% and 32.69%,respectively.(P = 0.395,0.049 and 0.029).When ETS was used to evaluate eustachian tube function,oxymetazoline could significantly improve ETS compared with saline,and ETS were 4.06 ± 2.42 and 5.32 ± 2.31(P = 0.00)and 3.93 ± 1.80 and 4.00 ± 1.78(P = 0.083).CONCLUSION: when eustachian tube manometer were used to evaluate the eustachian function.Eustachian tube dysfunction was found in most adult otitis media with effusion.Decongestant may improve the function of eustachian tube. |
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