Measurements of Eustachian Tube Dilation by Video Endoscopy

Objectives:To create techniques for measurement of parameters of Eustachian tube (ET) dilation as observed with video endoscopy.To study correlations of the parameters between healthy subjects and patients with ET dysfunction to determine if they may be important for clinical or investigational use. Study Design: Prospective study in an academic center. 3 groups of adults: healthy subjects, otitis media with effusion (OME), patulous ET. Intervention: Video software analyses were performed on video recordings from subjects' transnasal endoscopy to measure parameters of the tubal dilation cycle. Results: 24 ETs of 15 healthy subjects, 24 ETs of 15 patulous ET and 20 ETs of 13 OME patients. Mean values for healthy subjects: cycle time 995 ms (SD 404.7), valve opening time 10.5 ms (SD 6.34), torus rotation time 176 ms (SD 151.5 and angle of torus rotation 34.2° (SD 14.3). Palatal elevation, measured as a percentage of torus height was 34.8% (SD 16.6) and excursion of the antero-lateral wall 35.5 % (SD 16.3). Lateral excursion of the antero-lateral wall was significantly less in patulous ET (18.7%, SD 15.1, p = 0.001) and in dilatory dysfunction (23.9%, SD 21.7, p = 0.048). The other parameters were not statistically different between healthy subjects and patients. Conclusion: Lateral excursion of the ET's antero-lateral wall was significantly reduced in OME and patulous ET patients compared with healthy subjects. Evaluation of the excursion of the lateral wall of the ET, which is due to TVP muscle action, may be an important parameter for further clinical and research study.