Eustachian Tube Function in Patients with Cholesteatoma.

Dysfunction of the eustachian tube has been regarded as one of the causes of cholesteatoma. However, we found that the eustachian tube in a number of patients with cholesteatoma functioned normally.In this study, we examined patients with cholesteatoma to find out whether or not they had any dysfunction of the eustachian tube, and whether there was any relationship between the affected and the contralateral ear. Pathological conditions around the tympanic orifice of the tube were also examined to clarify the effect of the inflammation on the function of the eustachian tube.Eustachian tube function was tested in 131 ears of patients with cholesteatoma prior to ear surgery.1. Retraction-type cholesteatoma often showed normal opening pressure, and half of these ears showed normal tubal function.2. The majority of ears with the perforation type of cholesteatoma showed impaired tubal function and marked inflammation around the tympanic orifice of the tube.3. Almost all cholesteatoma ears showed poor pneumatization, suggesting impaired tubal function in childhood.4. Abnormal findings were frequent in the contralateral eardrum in patients with cholesteatoma. Retraction pockets which might be related to cholesteatoma were noted in about 30%. Thus, common pathogenic factors in the two ears were suspected to be important in the development of cholesteatoma.