Tympanoplasty and recurrent disease: sniff-induced high negative pressure in the middle ear space

Eustachian tube function was studied in 18 patients who had developed recurrent middle ear disease after middle ear surgery on one ear. The types of recurrent disease included recurrent retraction of the tympanic membrane, recurrent cholesteatoma, columella penetration, postoperative perforation, and infection. Pressures in both of the middle ears, as well as in the nasopharynx, were recorded simultaneously. The ears of patients in this study were found to be able to equalize pressure as well as did normal ears examined previously. However, in 12 of the 18 ears that had been operated on, failure of eustachian tube closing with sniff-induced negative pressure in the middle ear was found. Additionally, in three patients, a similar condition was present in the contralateral ear. It is concluded that postoperative complications of the types described may be correlated with tubal closing failure and sniff-induced high negative pressure in the middle ear space.