Assessment of long-term middle ear ventilation.

Pathologic changes of the middle ear cavity are almost invariably caused by eustachian tube malfunctions which are either permanent, fluctuating or recurrent. The process may deteriorate from middle ear effusion to atelectasis of the middle ear, adhesive otitis, and can potentially end in cholesteatoma. Close association with eustachian tube malfunction is common in the following conditions: cleft palate, allergy, obstructive lymphoid hypertrophy, hypoimmune state, etc. Negative intratympanic air pressures typify the above conditions, leading to the progressive pathology of the ear drum and cavity. Localized atelectatic retraction pockets signal the alarm of impending irreversible complications. They may be localized in any part of the eardrum, predominantly in the posterosuperior quadrant. Inpocketed by the continuous vacuum, these invaginations may fill with trapped epithelial debris. Re-establishment of adequate middle ear ventilation is the key in every attempt to arrest and reverse this pathology. Cl...