Eustachian Tube Function in Children with Normal Middle Ear and with Tympanic Membrane Retraction

Objectives: Identify the variation in middle ear pressure (MEP) after tubal function tests performed in normal children and in ears with retraction disease. Variability over time was analyzed. Methods: Observational cross‐sectional study. A total of 38 subjects were studied between March and November of 2012. Subjects were classified into three groups: group1‐normal ears (36 ears); group2‐mild tympanic membrane (TM) retractions (23 ears); group3‐moderate/severe TM retractions (17 ears). All patients had Valsalva maneuver, sniff test and Toynbee maneuver done sequentially in both ears twice with 15 days interval. MEP was measured with an Interacoustics AT235h tympanometer before and after the maneuvers. For analysis, MEP mixed effects models was used. For evaluation over time, Bland and Altman and intra‐class correlation (ICC) were used. Significance of the study was ± = 0.05. Results: The mean ± SD age was 11 ± 2.72 years (8‐17 years). At first time of the Valsalva maneuver, there was a trend of increasing pressures in the three groups (P = 0.012), and the mean pressures of the groups were different (P <0.001). For the sniff test and Toynbee there was no statistically significant difference between basal pressure and pressure after the maneuvers in three groups of ears (P >0.05) at the two times. We found a moderate degree of replicability over the two times of measurement. Conclusions: The average MEP increased in the Valsalva maneuver in the three groups. Pressure had more variability in ears with moderate/severe retraction.