Tympanic membrane mobility on otoscopy as an indicator of eustachian function.

Three hundred and twelve ears in 156 subjects were assessed. All the subjects were recruit volunteers to the Submarine and Diving branches of the Royal Navy, who were unable to equilibrate their middle ear pressures when exposed to an environment of increased ambient pressure. All these subjects were found to have a deformity of the vomero-ethmoid suture and underwent submucous resection of the nasal septum to correct their Nose-Ear Distress syndrome. Six weeks after operation each recruit was re-assessed otologically; 29 subjects (18.6%) had bilaterally immobile tympanic membranes and 6 subjects (3.9%) had an unilaterally immobile tympanic membrane on performance of Valsalva and Toynbee maneuvers. Nevertheless, 26 subjects (74.3%) were able to equilibrate their middle ear pressures at a depth equivalent to 10 meters of water. Because of this finding it can be stated that immobility of the tympanic membrane on performance of the Valsalva and Toynbee maneuvers does not necessarily denote the presence of eustachian tube dysfunction.