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Eustachian tube dysfunction in an intensive care unit: A prospective observational study.

S P Singh1, Awadhesh Kumar Mishra2, J R Galagali3

  • 1Classified Specialist (ENT-HNS), Command Hospital (Western Command), Chandimandir, India.

Medical Journal, Armed Forces India
|January 6, 2023
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Summary

Eustachian tube dysfunction is common in ICU patients, affecting over 27% of those admitted. This condition is significantly linked to factors like intubation and tracheostomy, highlighting a critical area for patient care.

Keywords:
Eustachian tube dysfunctionIntensive careMiddle ear effusionMiddle ear pressureTympanometry

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Area of Science:

  • Otolaryngology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Eustachian tube (ET) dysfunction is an underrecognized complication in hospitalized patients.
  • It can exacerbate patient morbidity, particularly in intensive care unit (ICU) settings.

Purpose of the Study:

  • To prospectively investigate the incidence of ET dysfunction in patients admitted to ICU versus non-ICU wards.
  • To identify factors associated with ET dysfunction development during hospitalization.

Main Methods:

  • A prospective observational study included patients hospitalized between December 2018 and June 2019.
  • Exclusion criteria included pre-existing ET dysfunction, ear/nose/sinus disease, head/neck tumors, radiotherapy, or glucocorticoid therapy.
  • Serial tympanometry was used to diagnose ET dysfunction (Type B, C1, C2 curves).

Main Results:

  • The ICU group (n=385) had a significantly higher incidence of ET dysfunction (27.79%) compared to the non-ICU group (2.3%, P < 0.0001).
  • Relative risk for ET dysfunction in the ICU group was 11.95 (95% CI 3.86 to 36.99).
  • Within the ICU, ET dysfunction was associated with endotracheal intubation, Ramsay sedation score, and duration of tracheostomy.

Conclusions:

  • The study reveals a high incidence of Eustachian tube dysfunction in patients admitted to the intensive care unit.
  • These findings underscore the importance of monitoring and managing ET dysfunction in critically ill patients.