Otitis media and eustachian tube caliber.

Clinical data supported the hypothesis that most otitis media requiring surgery is part of a life-long bilateral process that correlates with small mastoid air system, and with a bougie-assessable large eustachian tube. Cleft palate, even in the microform of cleft uvula, was an indicator of large eustachian tube (p less than 0.001). The 1.48 mm mean eustachian tube caliber of the otitis patients was larger (p less than 0.001) than the 0.73 mm mean of the reference eustachian tubes. Eustachian tube caliber was not a correlate of age or sex. Comparatively small caliber eustachian tubes were associated with trauma-caused tympanic membrane perforation (p less than 0.01), and middle ear effusion in allergic airway disease patients (p less than 0.05). Large eustachian tube caliber seemed a reliable correlate of the spectrum of manifestations of chronic otitis media.