Objective: In order to assess ET more comprehensively, sonotubometry (STM)combined with CT images were applied to investigate the opening features of eustachian tube (ET) in normal subjects. STM was also used as a monitor training ET opening maneuver and optimizing CT scan parameters. Methods: Following ET opening training monitored by STM, STM data of ET opening duration and maximum sound pressure from 13 healthy volunteers (10 males and 3 females, 22 to 26 years old) were acquired using maneuvers of swallowing and Valsalva in standing and supine positions. Two trials of CT scan, setting A (slice thickness 6.0 mm, manually simulated to 0.6 mm, reconstruction thickness 0.6 mm) for normal and Valsalva scans and setting B(slice thickness 0.4 mm,reconstruction thickness 0.4 mm)for Valsalva scan, were conducted in each subject. The bone area and cartilage area of ET were measured respectively in reconstructed CT images. Statistical software SPSS 19.0 was employed in data analysis. Results: The duration of ET opening and maximum sound pressure by Valsalva were longer and stronger than those by swallowing in both positions. For Valsalva maneuver, standing position resulted in longer ET opening duration compared to supine position (P<0.05). Under setting A, ET cartilage area was measured larger by Valsalva scan than by normal scan (P<0.05). By Valsalva scan, setting A captured larger ET cartilage area compared to setting B (P<0.05). CT setting B resulted in longer scan time in comparison to setting A (P<0.05). Conclusions: Techniques of STM in supine position plus CT scan under setting A can be combined by Valsalva passive ET opening. Not only the invisible ET lumen through routine CT scan can be illustrated, but also relevant ET open-close process is shown, therefore, this study provides the technique for ET research of function and structure.
Adult ; Deglutition ; Eustachian Tube/diagnostic imaging* ; Female ; Humans ; Male ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Valsalva Maneuver ; Young Adult

OBJECTIVE: To observe the anatomic characteristics of supratubal recess and the morphological change of it in the sick ear. To investigate the relation between the morphological changes of supratubal recess and otitis media. METHOD: Using high resolution CT to observe and measure the supratubal recess of the normal ears and the ailing ones. RESULT: For the normal adults, the anteroposterior diameter of the supratubal recess is (3.83 +/- 1.28) mm, the vertical diameter (3.67 +/- 1.14) mm, the height (3.76 +/- 0.36) mm; and the length of the cog is (2.84 +/- 0.38) mm. The size of the supratubal recess showed no significant difference between left and right (P>0.05). There was no relationship between the size of the supratubal recess and pneumatization of mastoid cells (P>0.05). There was significant differences in size of the supratubal recess between normal ears and the ears with cholesteatoma (P<0.05), but there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells (P>0.05) in the ears with cholesteatoma. There was no significant differences in size of the supratubal recess between normal ears and the ears with chronic otitis media (P>0.05). In the ears with cholesteatoma, 40% had osseous destruction in supratubal recess. CONCLUSION For the normal adults, the size of the supratubal recess showed no significant difference between left and right, and there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells. Anterior tympanic isthmus , posterior tympanic isthmus and supratubal recess which is the supplement of the formers constitute the air way between attic and mesotympanum. The supratubal recess of the cholesteatoma is smaller than the normal, when the eustachian tube dysfunction occurs, the air way in the middle ear would herein be affected, and cholesteatoma forms eventually. There was no significant differences in size of the supratubal recess between normal ears and ears with chronic otitis media, as in the clinic. The effect of the supratubal recess should be taken into account when we consider the pathogeny and treatment of the middle ear cholesteatoma.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Ear, Middle ; diagnostic imaging ; Eustachian Tube ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; diagnostic imaging ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVETo assess the value of multi-slice spiral CT (MSCT) and impedance audiometry in preoperative evaluation of eustachian tube function in patients with otitis media.

METHODSMSCT and impedance audiometry were performed in 61 patients with otitis media (63 ears), and the results were graded to analyze the correlation between the two examinations. The pathological changes at the tympanic orifice were recorded during surgical exploration of the eustachian tube, and the results were compared with those by MSCT and impedance audiometry.

RESULTSMSCT revealed normal findings in 8 ears, mild pathological changes in 19 ears, and severe changes in 36 ears. Soft tissue shadows at the tympanic orifice was found in 16 ears, and 47 ears were free of the shadows. Impedance audiometry showed normal findings in 20 ears, mild pathological changes in 15 ears, and severe changes in 28 ears. In surgical exploration, tympanic orifice lesions were detected in 22 ears, and were not detected in 41 ears. The rank correlation coefficient between MSCT and impedance audiometry was 0.706, suggesting a correlation between the two examinations. Goodness-of-fit test showed good match of the results of MSCT and surgical exploration (P=0.000, kappa=0.627).

CONCLUSIONMSCT combined with impedance audiometry provides a means for comprehensive evaluation of eustachian tube function and lesions, which greatly facilitates surgical planning and treatment of the lesions.

Acoustic Impedance Tests ; Adolescent ; Adult ; Eustachian Tube ; diagnostic imaging ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Otitis Media ; diagnostic imaging ; physiopathology ; Tomography, Spiral Computed ; Young Adult