The atelectatic ear.

Direct measurements of middle ear pressure were performed in 14 children with recurrent middle ear effusion and deep retraction of the tympanic membrane. In 12 of the 22 ears studied, measurements showed that a high negative pressure in the middle ear space had been induced by sniffing. Results suggest that a combination of closing failure of the Eustachian tube and sniffing is the cause of effusion and progressive retraction of the tympanic membrane in these patients. It is further suggested that cholesteatoma, which was present in three of the patients, was also a result of sniff-induced negative pressure in the middle ear space.