Methods to Improve the Efficacy of Autoinflation Procedures and to Classify Eustachian Tube Patency

We describe three methods to improve the efficacy of autoinflation procedures. The subjects were examined after flight with otoscopy and tympanometry. If the middle ear pressures after flight were negative, the passengers were asked to perform a Valsalva maneuver after which tympanometry was repeated. If still negative, the passengers were instructed to perform an extended Valsalva maneuver. If middle ear pressure was still negative, the passenger then was instructed to perform autoinflation using a nasal balloon. Among the ears with initial negative middle ear pressure, 14% normalized the middle ear pressure after Valsalva’s maneuver. In the passengers with a remaining negative pressure, the pressure was equalized to zero or positive pressure in 46% following an extended Valsalva maneuvre. In the ears with remaining negative middle ear pressure after both Valsalva and extended Valsalva maneuver, 69% could normalize the middle ear pressure after nasal balloon inflation.