Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T23:02:08.578Z Has data issue: false hasContentIssue false

Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media

Published online by Cambridge University Press:  15 March 2017

P M Picciotti*
Affiliation:
ENT Department, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
G Della Marca
Affiliation:
Institute of Neurology, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
L D'Alatri
Affiliation:
ENT Department, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
D Lucidi
Affiliation:
ENT Department, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
M Rigante
Affiliation:
ENT Department, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
E Scarano
Affiliation:
ENT Department, Agostino Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy
*
Address for correspondence: Dr P M Picciotti, Department Head and Neck Surgery, Institute of Otorhinolaryngology, Agostino Gemelli Hospital, Catholic University School of Medicine and Surgery, Largo A. Gemelli n.1, 00168 Rome, Italy Fax: +39 63051194 E-mail: pmpicciotti@rm.unicatt.it

Abstract

Background:

The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing.

Methods:

Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed.

Results:

In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation.

Conclusion:

This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Seibert, JW, Danner, CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am 2006;39:1221–35Google Scholar
2 Corbeel, L. What is new in otitis media? Eur J Pediatr 2007;166:511–19Google Scholar
3 Teixeira, MS, Banks, J, Swarts, JD, Alper, CM, Doyle, WJ. Eustachian tube opening measured by sonotubometry is poorer in adults with a history of past middle ear disease. Int J Pediatr Otorhinolaryngol 2014;78:593–8Google Scholar
4 Bluestone, CD, Doyle, WJ. Anatomy and physiology of eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol 1988;81:9971003 CrossRefGoogle ScholarPubMed
5 Honjo, I, Ushiro, K, Haji, T, Nozoe, T, Matsui, H. Role of the tensor tympani muscle in Eustachian tube function. Acta Otolaryngol 1983;95:329–32Google Scholar
6 Doyle, WJ, Mandel, EM, Seroky, JT, Swarts, JD, Casselbrant, ML. Reproducibility of the forced response test in children with chronic otitis media with effusion. Otol Neurotol 2013;34:1621 CrossRefGoogle ScholarPubMed
7 Dinç, AE, Damar, M, Uğur, MB, Öz, II, Eliçora, , Bişkin, S et al. Do the angle and length of the eustachian tube influence the development of chronic otitis media? Laryngoscope 2015;125:2187–92CrossRefGoogle ScholarPubMed
8 Swarts, JD, Casselbrant, ML, Teixeira, MS, Mandel, EM, Richert, BC, Banks, JM et al. Eustachian tube function in young children without a history of otitis media evaluated using a pressure chamber protocol. Acta Otolaryngol 2014;134:579–87Google Scholar
9 Bluestone, CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J 1996;15:281–91CrossRefGoogle ScholarPubMed
10 Scarano, E, Fetoni, AR, Picciotti, P, Cadoni, G, Galli, J, Paludetti, G. Can chronic nasal obstruction cause dysfunction of the paratubal muscles and otitis media? An experimental study in developing Wistar rats. Acta Otolaryngol 2003;123:288–91Google Scholar
11 D'Alatri, L, Picciotti, PM, Marchese, MR, Fiorita, A. Alternative treatment for otitis media with effusion: eustachian tube rehabilitation. Acta Otorhinolaryngol Ital 2012;32:2630 Google Scholar
12 Gersdorff, M, Cambier, C, Huysbrechts-Forester, V. The tubal logotherapy [in French]. Les Cahiers d’ ORL 1986;21:676–82Google Scholar
13 Stangerup, SE. Autoinflation: historical highlights and clinical implications. Ear Nose Throat J 1998;77:740–2CrossRefGoogle ScholarPubMed
14 Arick, DS, Silman, S. Treatment of otitis media with effusion based on politzerization with an automated device. Ear Nose Throat J 2000;79:290–2Google Scholar
15 Picciotti, PM, Rigante, M, Della Marca, G, Restuccia, D, Scarano, E. Tensor veli palatini electromyography with surface electrode applied transnasally. Acta Otorhinolaryngologica Ital 2005;25:120–4Google Scholar
16 Restuccia, D, Di Lazzaro, V, Valeriani, M, Mariotti, P, Torrioli, MG, Tonali, P et al. Brain-stem somatosensory dysfunction in a case of long-standing left hemispherectomy with removal of the left thalamus: a nasopharyngeal and scalp SEP study. Electroencephalogr Clin Neurophysiol 1996;100:184–8CrossRefGoogle Scholar
17 Kapila, YV, Dodds, WJ, Helm, JF, Hogan, WJ. Relationship between swallow rate and salivary flow. Dig Dis Sci 1984;29:528–33Google Scholar
18 Doyle, WJ. Functional eustachian tube obstruction and otitis media in a primate model. A review. Acta Otolaryngol Suppl 1984;414:52–7CrossRefGoogle Scholar
19 Casselbrant, M, Cantekin, EI, Dirkmaat, DC, Doyle, WJ, Bluestone, CD. Experimental paralysis of tensor veli palatini muscle. Acta Otolaryngol 1988;106:178–85Google Scholar
20 Doyle, WJ, Ingraham, BA, Saad, MM, Cantekin, EI. Primate model of cleft palate and middle ear disease: results of one-year post-cleft follow-up. In: Lim, DJ, Bluestone, CD, Klein, JO, Nelson, JD, eds. Recent advances in otitis media with effusion: proceedings of the third international symposium, May 17–20, 1983 Fort Lauderdale, Florida. Philadelphia: BC Decker, 1984:215–18Google Scholar
21 White, BL, Doyle, WJ, Bluestone, CD. Eustachian tube function in infants and in children with Down's syndrome. In: Lim, DJ, Bluestone, CD, Klein, JO, Nelson, JD, eds. Recent advances in otitis media with effusion: proceedings of the third international symposium, May 17–20, 1983 Fort Lauderdale, Florida. Philadelphia: BC Decker, 1984:62–6Google Scholar
22 Bhat, VK, Kumar, PR, Nag, M, Hegde, J. Comparison of a eustachian barotubometer with a tympanometer to evaluate eustachian tube function in chronic suppurative otitis media. J Otolaryngol Head Neck Surg 2009;38:456–61Google Scholar
23 Bylander, A, Tjernstrom, O, Ivarsson, A, Ingvarsson, L. Eustachian tube function in children with and without otologic history. In: Lim, DJ, Bluestone, CD, Klein, JO, Nelson, JD, eds. Recent advances in otitis media with effusion: proceedings of the third international symposium, May 17–20, 1983 Fort Lauderdale, Florida. Philadephia: BC Decker, 1984; 115 Google Scholar
24 Alper, CM, Swarts, JD, Singla, A, Banks, J, Doyle, WJ. Relationship between the electromyographic activity of the paratubal muscles and eustachian tube opening assessed by sonotubometry and videoendoscopy. Arch Otolaryngol Head Neck Surg 2012;138:741–6Google Scholar
25 Mandel, EM, Swarts, JD, Casselbrant, ML, Tekely, KK, Richert, BC, Seroky, JT et al. Eustachian tube function as a predictor of the recurrence of middle ear effusion in children. Laryngoscope 2013;123:2285–90CrossRefGoogle ScholarPubMed
26 De Bleecker, JL. How to approach the patient with muscular symptoms in the general neurological practice? Acta Neurol Belg 2005;105:1822 Google Scholar
27 Sapci, T, Mercangoz, E, Evcimik, MF, Karavus, A, Gozke, E. The evaluation of the tensor veli palatini muscle function with electromyography in chronic middle ear diseases. Eur Arch Otorhinolaryngol 2008;265:271–8Google Scholar
28 Hairston, LE, Sauerland, EK. Electromyography of the human palate: discharge patterns of the Levator and Tensor Veli Palatini. Electromyogr Clin Neurophysiol 1981;21:287–97Google Scholar
29 Kamere, DB. Electromyographic correlation of tensor tympani and tensor veli palatini muscles in man. Laryngoscope 1978;88:651–62Google Scholar
30 Guindi, GM, Payne, JK, Higenbottan, TW Clinical electromyography in ear, nose and throat practice. J Laryngol Otol 1981;95:407–13CrossRefGoogle ScholarPubMed
31 Honjo, I, Kumazawa, T, Honda, K, Shimojo, S. Electromyographic study of patients with dysfunction of the Eustachian Tube. Arch Otolaryngol 1979;222:4751 Google Scholar
32 Su, C-Y, Hsu, S-P, Chee, EC-Y. Electromyographic recording of tensor and levator veli palatini muscles: a modified transnasal insertion method. Laryngoscope 1993;103:459–62CrossRefGoogle ScholarPubMed