Evaluating the Eustachian Tube Function in Chronic Suppurative Otitis Media in Reference to its Treatment Outcome

Background: Tubal malfunction is the most important factor in the development and persistence of otitis media. When the Eustachian tube malfunction persists, the most carefully performed surgery will fail because the initiating pathogenetic factors of Eustachian tube function and middle ear ventilation are still present. Measurement of the Eustachian tube function is therefore an important part of the medical and surgical evaluation of the middle ear disease.

Aims:

The study was undertaken to find out Eustachian tube function in safe type of chronic suppurative otitis media and to study the comparison of graft uptake in normal, partially impaired and grossly impaired Eustachian tube function in safe type of chronic suppurative otitis media.

Methods:

The present prospective study was conducted in the department of otorhinolaryngology and Head and Neck surgery, SMGS Hospital, Jammu w.e.f November 2016 to October 2017. The study was conducted after taking approval of institutional Ethics committee. The patients attending ENT outpatient department were enrolled in the study. Patients were diagnosed clinically and also audiometrically by Pure Tone Audiometry and impedance audiometry. Eustachian tube function test- TOYNBEE test was done in all the patients. An equal number of patients with normal, partially impaired and grossly impaired Eustachian tube function were considered for surgery.
Results: Out of 20 patients with normal Eustachian tube function, 19(95%) showed graft uptake. Out of 20 patients with partially impaired Eustachian tube function, 18(90%) showed graft uptake. Out of 20 patients with grossly impaired Eustachian tube functions 13(65%) showed graft uptake. Comparison of mean values of pre and post- operative AB gap with respect to normal, partially impaired and grossly impaired Eustachian tube functions .Comparison is highly significant statistically with (p< 0.001).

Conclusion: ETF testing by impedance audiometry is a simple non-invasive method of testing the ETF. As seen in our study, functioning Eustachian tube is an important requirement for optimum outcome of myringoplasty. Testing the functions of Eustachian tube before surgery provides a possibility of predicting the possible outcome of myringoplasty / tymapanoplasty. This is also concluded that a partially functioning Eustachian tube should not be considered to be a contraindication to these surgeries as in many of these cases graft uptake and AB –gap closure was good (90%).