Inadequate opening capacity of the eustachian tube in Meniere's disease

Abstract

Conclusion: In this physiological study subjects with Meniere's disease (MD) had high resistance to opening of the eustachian tube (ET) in three of four provocation tests. These subjects can be exposed to pressure deviations in the middle ear (ME) above their equalizing capacity. Transmission of the pressure deviations to the inner ear fluids and influence of the symptoms of MD are feasible. Objective: The aim of the study was to reveal potential inadequacy in the ET equilibration capacity and deviations in ME pressure in patients with MD. Methods: Direct ME pressure measurements were made during provocation tests of the ET, and continuously during the daytime and night-time in 21 patients with unilateral, definite and active MD. Twenty subjects with healthy ears (HEs) were used for comparison. Results: In all, 15/21 subjects could not equilibrate an induced positive and/or negative pressure in the ME by deglutition; 9/21 subjects were not able to perform Valsalva's manoeuvre. All the controls could effectively perform these manoeuvres. However, the continuous measurements showed a similar pressure pattern in patients with MD and the controls, i.e. a slightly negative mean ME pressure during the daytime and positive pressure during sleep.

Keywords::

• Middle ear pressure
• provocation test
• continuous measurement
• pressure equilibration
• daytime and night-time recording
• ventilation tubes
• tubal function
• inner ear pressure
• Valsalva's test

Acknowledgments

This study was supported by research grants from Helga Hjerpstedt's fund, Agnes Ljunggren's fund and grants from the Medical Faculty of Lund University.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.