The effect of nasal continuous positive airway pressure on normal ears and on ears with atelectasis.

OBJECTIVES

The effect of short-term nasal continuous positive airway pressure (CPAP) on normal and atelectatic ears was studied to investigate the effect of positive pressure on these ears.

STUDY DESIGN AND SETTING

This is a prospective study performed at the ear, nose, and throat clinic of a district general hospital. No randomization was designed for this study.

PATIENTS

The study on the normal ears was performed on healthy volunteers, whereas the study on atelectatic ears was performed on patients who had difficulty in performing the Valsalva maneuver.

INTERVENTION

Tympanometry, audiometry, and electronystagmography were performed on normal subjects before, during, and immediately after a single use of nasal CPAP. In the group of atelectatic ears, otoscopy and audiometry were performed before and immediately after the use of nasal CPAP (3 hours).

MAIN OUTCOME MEASURE

The change in the middle ear pressure and hearing on the normal ears during the use of nasal CPAP was measured. In the group with atelectatic ears, the incidence of reinflation of the collapsed eardrum after the use of nasal CPAP was measured.

RESULTS

Positive pressure was recorded in all the middle ears during the use of nasal CPAP, resulting in a reversible hearing impairment. More than two thirds of the atelectatic eardrums could be reinflated by a single use of nasal CPAP.

CONCLUSION

Nasal CPAP could be used to deliver positive pressure into the middle ear and, hence, could be used as a device to reinflate a collapsed eardrum in many atelectatic ears.