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Eustachian Tube Dysfunction in Adhesive Otitis Media: Obstructive Versus Patulous Types.

Seong Hoon Bae^1,2, Tae Uk Cheon^1,2, Sung Il Cho³

¹Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|February 17, 2025

Summary

This study identifies a distinct patulous adhesive otitis media (AdOM) subtype linked to patulous Eustachian tube dysfunction (PET). Differentiating patulous from obstructive AdOM is vital for effective treatment and avoiding symptom exacerbation.

Keywords:

adhesive otitis media balloon Eustachian tuboplasty obstructive Eustachian tube dysfunction patulous Eustachian tube dysfunction

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Area of Science:

Otolaryngology
Medical Diagnostics
Eustachian Tube Physiology

Background:

Adhesive otitis media (AdOM) has distinct subtypes crucial for treatment selection, like balloon Eustachian tuboplasty (BET).
Patulous Eustachian tube dysfunction (PET) associated AdOM is understudied.
Distinguishing between patulous and obstructive Eustachian tube (ET) function is essential for managing AdOM.

Purpose of the Study:

To describe the characteristics of patulous AdOM associated with PET.
To define the patulous type of AdOM.
To differentiate patulous AdOM from obstructive AdOM.

Main Methods:

Prospective cohort study involving 62 ears from patients with AdOM, PET, and traumatic perforation.
Endoscopic examinations, symptom questionnaires, and modified inflation-deflation tests to evaluate passive ET opening pressure.
Comparison between obstructive-AdOM, patulous-AdOM, PET, and a control group.

Main Results:

Patulous-AdOM identified in 43% of patients.
Significantly lower median opening pressures in patulous-AdOM (222 daPa) compared to obstructive-AdOM (400 daPa) and PET (<100 daPa).
Habitual sniffing reported in 92.3% of patulous-AdOM patients; reduced mastoid pneumatization noted in both subtypes.

Conclusions:

Accurate differentiation between patulous and obstructive AdOM is critical as BET can worsen symptoms in patulous cases.
Comprehensive ET function evaluation is necessary before treatment.
Tailored management approaches are essential for AdOM.