eustachian tube function tests.pptx

Study

1. Eustachian function tests Presented by Gauri Shankar Saini

2. Index Valsalva Test Politzers Test Catheterization Toynbee's Test Tympanometry Radiological Test Saccarrine or methylene blue test Sonotubometry

3. Valsalva Test Principle :-- build positive pressure in the nasopharynx so that air enters into the eustachian tube If air enters into the middle ear tympanic membrane will move outward Hissing sound produced in case of TM perforation Cracling sound produced in case of discharge from middle ear Performance rate is 65% Avoiding in:- atrophic scar of TM,presence of infection in nose and nasopharynx.

4. Politzers Test In children Principle:-- olive shape tip of politzers bag introduced into the patient nostril on the side of which the tubal function is desired to be tested . Other nostril is closed and the bag compressed while at the same time the patient swallows Hissing sound is heared if the tube is patent. Also used in ventilation of middle ear

5. Catheterization Nose anaesthesized by lignocaine Catheter is passed along the floor of the nose till it reaches the nasopharynx It is rotated 90° medially and pulled back till the engagement on the posterior border of nasal septum It is then rotated 180° laterally so that the tip lies against the tubal opening Now we connect politzers bag to catheter and air insufflated Entery of air is tested by auscultation tube

6. Complications in catheterization Scaring of eustachian tube opening by injury Bleeding from nose Transmission of infection in the middle ear causing ootitis media Rupture of atrophic area of TM

7. Toynbees Test Based on negative pressure Physiological test It is performed by asking the patient to swallow while nose has been pinched,this draws air from the middle ear into the nasopharynx and causes inward movement of TM

8. Tympanometry Negative and positive pressure created in external ear canal and the patient swallows repeatedly Ability to equaliberate negative and positive pressure to the ambient pressure indicates normal tubal function Done in both cases of perforated and intact TM

9. Radiological Test Radioopaque dye:- hypaqe,lipoidal instilled into the middle ear through a pre-existing perforation and X rays taken should delineate the tube and any obstruction Time taken by the dye to reach the nasopharynx also indicates clearance test function

10. Saccarine or methylene blue test saccarine solution is Placed into middle ear The time taken by it to reach the pharynx and impart a sweet taste is also a measure of clearance function test Methylene blue dye can be instilled into the middle ear and the time taken by it to stain the pharyngeal secretions can be noted

11. Sonotubometry Tone is presented to nose Record from external canal Tone louder while tube is patent It also tells duration for which the tube remains open Non invasive procedures Provide information about active tubal opening