Continuous long-term measurements of the middle ear pressure in subjects with symptoms of patulous eustachian tube.

Direct middle ear (ME) pressure measurements during 24 h and tubal function tests were performed on 11 subjects with the clinical diagnosis patulous Eustachian tube (PET). The pressure was recorded from the ME via a perforation in the tympanic membrane. The method used has previously been reported in a study on subjects with normal ME function and no symptoms of PET: a normal group. Results from tubal function tests correlated well with the clinical diagnosis of PET and the sniff test was positive in most subjects. Continuous ME pressure measurements during normal everyday and night-time activities showed no indications of pressure changes induced by sniffing. Subjects with the clinical diagnosis PET did not have a static state of an open ET. The ME pressure varied during the day and night, indicating that the function of the ET changed over time from a closed to an open state. Subjects with PET had a long-term pressure pattern significantly different from that of a normal group, a difference seen in the erect as well as in the recumbent position during the night. The subjects demonstrated a negative mean pressure level in the recumbent position during the night, whereas the normal group had a slight positive mean pressure. The difference was statistically significant. Many subjects demonstrated frequent slow rate negative pressure trends during normal day-time and night-time activities. Long-term continuous pressure measurements seem to add valuable information to that of conventional tubal function tests.