eustachian tube physiology ppt
Post on 09-Jan-2017
211 Views
Preview:
TRANSCRIPT
ETFUNCTION
GAJALAKSHMI
EMBRYOLOGY AND POSTNATALDEVELOPMENT
• The eustachian tube is derived from the first pharyngeal pouch
ET Adults and Children
PHYSIOLOGY
• pressure equalization,• mucociliary clearance and “drainage,”• protection from both the influences of the
nasopharyngeal environment and loud sounds.
• Role of surfactant• Parasympathetic tone
• hydrops ex vacuo model-Politzer• flask model-Bluestone
MUCOCILIARY CLEARANCEAND DRAINAGE
• programmed movement of the mucous blanket out of the eustachian tube
• epithelium of the tube are covered with cilia• goblet cells-floor of the tube• Aquaporins• Surfactant• Mucins
PROTECTION
• the closed orifice of the cartilaginous eustachian tube
• Lyzozyme,lactoferrin,betadefencins and colectin
• MALT• Surfactant proteins - host defense• Sound protection
EUSTACHIAN TUBE FUNCTION ASSESSMENT
• History and Physical Examination• Pneumatic Otoscopy
• Nasopharyngoscopy • Imaging of the Eustachian Tube-MRI
Valsalva’s Test
POLITZER’S TEST
EUSTACHIAN TUBE CATHETERIZATIONATTACHED TO A PRESSURE SYSTEM TO INSUFFLATE THE
MIDDLE EAR
TYMPANOMETRY
Holmquist’s method 1. A tympanogram is recorded to determine the initial middle-ear
pressure. 2. A negative pressure is created in the nasopharynx by a
pressure device connected to the nose, and the subject is asked to swallow to establish a negative pressure of about 200 mm H2O in the middle ear. 3. A second tympanogram is recorded to evaluate the exact negative middle-ear pressure achieved. 4. The patient is told to swallow repeatedly 5. A third tympanogram -the final middle- ear pressure
PATULOUS EUSTACHIAN TUBE
Bluestone’s nine-step test
Sonotubometry
• An earphone: could generate a continuous sound of 6, 7, or 8 kHz sound of 6, 7, or 8 kHz Æ inserted into inserted into the nostril of the test subject the nostril of the test subject
• Sound source: � �• A microphone embedded in a circumaural ear
muff was placed in the ear muff was placed in the ipsilateral external auditory canal external auditory
• The microphone and insert earphone The microphone and insert earphone Æ were connected to a heterodyne
• A continuous tone generated by the oscillator with filter set with filter set &the earphone inserted into the nose �
• Test sound the external auditory canal - picked up by a calibrated condenser microphone picked up connected to a preamplifier connected to a sound level recorder recorder
When TM is not intact
• Manometry• Forced response test• Clearance test• Modified inflation and deflation test
My ref
• Cummings 3rd edition• Bluestone CD, Shurin PA. Middle-ear diseases in
children: pathogenesis,diagnosis, and management. Pediatr Clin North Am 1974;21:379–400.
• Sando I, Takahashi H, Matsune S, Aoki H. Localization of function in the Eustachian tube: a hypothesis. Ann Otol Rhinol Laryngol 1994;103
top related