Eustachian tube function varies over time in children with secretory otitis media

Impaired opening and closing functions of the Eustachian tube are considere d to be pathogenic factors in secretory otitis media (SOM). As the clinical course of SOM is variable, the variability of tubal function is of interes t. We aimed to explore the short- and long-term variability of tubal openin g and closing functions in SOM. The study comprised 42 ears in 21 children (13 males and 8 females) with tympanostomy tubes due to SOM. The middle ear pressure was recorded during repealed passive forced openings, equalizatio n of + 100 daPa and - 100 daPa by swallowing, Valsalva inflation and forcef ul sniffing. Test sessions were performed twice (separated by 30 min) on ea ch of 2 days, with a mean interval of 3.7 months in between. In the forced opening lest there was a considerable intra-individual variability over tim e. Expressed as SD of the mean, the variability of the forced opening and c losing pressures in individual ears was on average 15% and 23%, respectivel y, between sessions and 20% and 30%, respectively, between test days. In th e equalization, Valsalva and sniff tests the rates of responses that change d from positive to negative between sessions and test days ranged-from 12% to 33%. Female gender and retraction pockets were related to poorer opening function in the forced opening test. Ears with serous effusion (in contras t to mucoid) showed a similar trend and also a lower occurrence of positive equalization, Valsalva and sniff rests. It was concluded that Eustachian t ube opening and closing Functions are highly variable in ears with SOM. Con sequently, single tubal function tests have low value when used as a progno stic tool in individual ears.