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Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation

Published online by Cambridge University Press:  31 July 2017

O Ilan ,
E-L Marcus ,
Y Cohen ,
T Farkash ,
R Levy ,
A Sasson  and
C Adelman
O Ilan*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel Chronic Ventilator-Dependent Unit, Herzog Hospital, Jerusalem, Israel
E-L Marcus
Affiliation:
Chronic Ventilator-Dependent Unit, Herzog Hospital, Jerusalem, Israel
Y Cohen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
T Farkash
Affiliation:
Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel
R Levy
Affiliation:
Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel
A Sasson
Affiliation:
Chronic Ventilator-Dependent Unit, Herzog Hospital, Jerusalem, Israel
C Adelman
Affiliation:
Speech and Hearing Center, Hadassah-Hebrew University Medical Center, Jerusalem, Israel Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel
*
Address for correspondence: Dr O Ilan, Department of Otolaryngology – Head & Neck Surgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel. E-mail: ofir.ilan@mail.huji.ac.il
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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.

Keywords

Intubation, gastrointestinalOtitis media with effusionRespirationArtificialTracheostomyEustachian Tube
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 9 , September 2017 , pp. 817 - 822
Copyright
Copyright © JLO (1984) Limited 2017 

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