Site of eustachian tube dysfunction in patients with otitis media with effusion.

This study was conducted to identify an exact site of ventilatory dysfunction within the eustachian tube among patients with otitis media with effusion (OME). Using 10 adults with OME, a fine polyethylene tube with a small pore at its tip was inserted into the eustachian tube via its pharyngeal orifice. Negative middle ear pressure was applied through a ventilation tube in the eardrum, and the patients were asked to swallow repeatedly at every 5-mm depth of insertion of the polyethylene tube toward the middle ear. Negative middle ear pressure could be equilibrated by swallowing within 10 mm of tube advancement from the pharyngeal orifice of the eustachian tube in seven of ten patients. It was concluded that the site of tubal ventilatory dysfunction is in the distal part of the cartilaginous portion of the eustachian tube in most adult patients with OME.