Open AccessEustachian Tube Function in 6‐Year‐Old Children with and without a History of Middle Ear Disease
Author(s) -
Mandel Ellen M.,
Casselbrant Margaretha L.,
Richert Beverly C.,
Teixeira Miriam S.,
Swarts J. Douglas,
Doyle William J.
Publication year - 2016
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599815620149
Subject(s) - eustachian tube , medicine , middle ear , otitis , acute otitis media , confidence interval , ear disease , surgery , audiology , hearing loss
Objective To test the hypothesis that eustachian tube opening efficiency, measured as the fractional gradient equilibrated (FGE), is lower in 6‐year‐old children with no middle ear disease but a well‐documented history of recurrent acute otitis media, as compared with children with a negative disease history (control). Study Design Cross‐sectional study. Setting Tertiary care pediatric hospital. Subjects and Methods Bilateral eustachian tube function was evaluated in 44 healthy 6‐year‐old children (19 boys, 29 white). None had middle ear disease at the time of testing, but 23 had a history of recurrent acute otitis media. Twenty‐one had no significant past otitis media. Eustachian tube function was measured with a pressure chamber protocol that established negative middle ear gauge pressures (referenced to the chamber pressure) and recorded that pressure before and after a swallow. FGE was calculated as the change in middle ear gauge pressure with swallowing divided by the preswallow pressure. Between‐group comparisons of the preswallow pressures and FGEs were made with a 2‐tailed Student’s t test. Results FGE was independent of the preswallow middle ear gauge pressure. For the 39 and 44 evaluable ears in the control and recurrent acute otitis media groups, the mean preswallow pressures were −194 daPa (95% confidence interval [95% CI] = −211 to −177) versus −203 (95% CI = −216 to −190; P >. 40), and FGEs were 0.32 (95% CI = 0.21‐0.43) vs 0.16 (95% CI = 0.08‐0.24; P =. 016), respectively. Conclusion In children with past recurrent acute otitis media, residual eustachian tube opening inefficiency is maintained after they have “outgrown” their middle ear disease.