Variability of eustachian tube function: Comparison of ears with retraction disease and normal middle ears

Objective: To explore the short-term and long-term variability of tubal ope ning and closing in ears with advanced retractions and in healthy ears, Stu dy Design/Methods: Twenty ears with retraction type middle ear disease (R-M ED) and 20 normal ears underwent direct recording of the middle ear pressur e during repeated forced openings, equalization of +100 daPa and -100 daPa by swallowing, Valsalva inflation, and forceful sniffing. Tests were perfor med twice (separated by 30 min) on each of 2 days separated by 3 to 4 month s. Results: There was considerable intraindividual variability of the force d opening pressure and the closing pressure in both groups, within as well as between sessions and test days, Although the variability was 1.5 to 2 ti mes higher in ears with retraction than in the normal group, mean Po and Pc did not differ between the groups. Compared with normal ears, ears with re traction changed more frequently from a positive to negative test response, or vice versa, when re-tested after 30 minutes. Rates of positive response in the equalization and Valsalva tests were significantly lower in disease d ears compared with normal ears. Conclusions: Eustachian tube opening and closing functions vary more in ears with retraction disease than in normal ears, which is consistent with the variable clinical course of R-MED and im plies that single tubal function tests have Little prognostic value on the individual level.