Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation. Issue 9 (31st July 2017)

• Record Type: Journal Article
• Authors: Ilan, O; Marcus, E-L; Cohen, Y; Farkash, T; Levy, R; Sasson, A; Adelman, C
• Is Part Of: Journal of laryngology & otology. Volume 131:Issue 9(2017)
• Page Start: 817
• Page End: 822
• Publication Date: 2017-07-31
• Subjects: Intubation, gastrointestinal, -- Otitis media with effusion, -- Respiration, -- Artificial, -- Tracheostomy, -- Eustachian Tube; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1017/S0022215117001554
• Languages: English
• ISSNs: 0022-2151

Abstract

Abstract: Objective: This study aimed to investigate the prevalence of and risk factors for Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation via tracheostomy tube. Methods: A total of 40 patients on chronic ventilation were included in a prospective cohort study. Middle-ear status was determined by tympanometry. Tympanograms were categorised as types A, B or C; types B and C were defined as middle-ear pathology. Results: In all, 57 ears of 40 patients were examined. Disease was found in at least 1 ear in 26 out of 40 patients. Middle-ear pathology was found in 25 out of 34 patients who were tube fed (via nasogastric tube or percutaneous endoscopic gastrostomy) vs 1 patient out of the 6 fed orally ( p = 0.014), and in 23 out of 31 with conscious or cognitive impairment vs 3 out of 9 cognitively intact patients ( p = 0.044). Conclusion: Middle-ear pathology is common in patients on chronic mechanical ventilation via tracheostomy tube. The highest prevalence was in those with impaired consciousness or cognition, and oral feeding appeared protective.