Primary deficits in eustachian tube function in patients with otitis media with effusion

A study was performed to detect primary and secondary deficits in eustachian tube (ET) function in children with otitis media with effusion (OME). We examined ET function in the active and convalescent stages of OME in a total of 103 children (141 ears) and compared the results with those obtained in a control group of 34 ears. There were 27 children (33 ears) with OME in the convalescent stage and 76 children (108 ears) in the group with active OME. The test of ET function included the inflation-deflation test and dye clearance test. No cases of abnormally high tubal opening pressure were found in the convalescent OME group, and only 11% of ETs in the active OME group had high pressure. Negative middle ear pressure equalizing function, which was impaired in 97.2% of ETs in the active OME group, was still found to be impaired in 93.9% of ETs in the convalescent OME group. Eustachian tube clearance was impaired in 64.0% of ears with OME in the active stage; this percentage decreased considerably to 36.0% in ears in the convalescent stage of OME. We conclude that poor ability to equalize negative pressure is a fundamental deficit of ET function in OME; impaired clearance function of ET in the active stage of OME is not considered to be a primary cause of OME; there is almost no organic obstruction or stenosis of the ET in patients with OME.