Research Article

Eustachian tube dysfunction in patients with severe sleep disordered breathing: evidence from inflation-deflation test


Background and Aim: Some risk factors for obstructive sleep apnea (OSA) such as upper respiratory airways abnormalities and obesity overlap with the risk factors for Eustachian tube dysfunction (ETD). In this study, we investigated the prevalence of ETD in a population of patients with OSA.
Methods: Tubal dysfunction was determined by tympanometry and inflation-deflation test in 36 patients diagnosed with severe OSA and 20 normal participants.
Results: More than 80% of patients with OSA had concomitant ETD at least in one ear. Obese participants had a smaller tympanometric peak pressure (TPP) shift after inflation-deflation test than non-obese subjects. There was no signifycant correlation between TPP shift and duration of OSA.
Conclusion: High prevalence of concomitant ETD was determined in patients with severe OSA and obese individuals. Tubal function testis suggested in patients referred for OSA evaluation.

1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-5.
2. Mirrakhimov AE, Sooronbaev T, Mirrakhimov EM. Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC Pulm Med. 2013;13:10.
3. Taranto Montemurro L, Kasai T. The upper airway in sleep-disordered breathing: UA in SDB. Minerva Med. 2014;105(1):25-40.
4. Huang JF, Chen GP, Wang BY, Xie HS, Zhao JM, Wu LH, et al. Assessment of upper-airway configuration in obstructive sleep apnea syndrome with computed tomography imaging during müller maneuver. Respir Care. 2016;61(12):1651-1658.
5. Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T. Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath. 2011;15(3):425-9.
6. Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ. Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med. 2011;14(5):335-8.
7. Bluestone CD. Eustachian tube: structure, function, role in otitis media. Hamilton, Ontario: BC Decker; 2005.
8. Kurien R, Chrisolyte S, Rupa V. Inflation-deflation test as a predictor of aditus patency in patients with chronic suppurative otitis media. Indian J Otolaryngol Head Neck Surg. 2009;61(3):169-72.
9. Smith ME, Tysome JR. Tests of Eustachian tube function: a review. Clin Otolaryngol. 2015;40(4):300-11.
10. McBride TP, Derkay CS, Cunningham MJ, Doyle WJ. Evaluation of noninvasive eustachian tube function tests in normal adults. Laryngoscope. 1988;98(6 Pt 1):655-8.
11. Uzun C. Evaluation of predive parameters related to eustachian tube dysfunction for symptomatic middle ear barotrauma in divers. Otol Neurotol. 2005;26(1):59-64.
12. Robison JG, Wilson C, Otteson TD, Chakravorty SS, Mehta DK. Increased eustachian tube dysfunction in infants with obstructive sleep apnea. Laryngoscope. 2012;122(5):1170-7.
13. Tsara V, Amfilochiou A, Papagrigorakis MJ, Georgopoulos D, Liolios E. Guidelines for diagnosis and treatment of sleep-related breathing disorders in adults and children. Definition and classification of sleep related breathing disorders in adults: different types and indications for sleep studies (Part 1). Hippokratia. 2009;13(3):187-91.
14. Hidir Y, Ulus S, Karahatay S, Satar B. A comparative study on efficiency of middle ear pressure equalization techniques in healthy volunteers. Auris Nasus Larynx. 2011;38(4):450-5.
15. Poe DS, Pyykkö I, Valtonen H, Silvola J. Analysis of eustachian tube function by video endoscopy. Am J Otol. 2000;21(5):602-7.
16. Susarla SM, Thomas RJ, Abramson ZR, Kaban LB. Biomechanics of the upper airway: Changing concepts in the pathogenesis of obstructive sleep apnea. Int J Oral Maxillofac Surg. 2010;39(12):1149-59.
17. Hui DS, Ko FW, Chu AS, Fok JP, Chan MC, Li TS, et al. Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea. Respir Med. 2003;97(6):640-6.
18. Liu SY, Huon LK, Lo MT, Chang YC, Capasso R, Chen YJ, et al. Static craniofacial measurements and dynamic airway collapse patterns associated with severe obstructive sleep apnoea: a sleep MRI study. Clin Otolaryngol. 2016;41(6):700-6.
19. Segal Y, Malhotra A, Pillar G. Upper airway length may be associated with the severity of obstructive sleep apnea syndrome. Sleep Breath. 2008;12(4):311-6.
20. McCormick JP, Hildrew DM, Lawlor CM, Guittard JA, Worley NK. Otic barotrauma resulting from continuous positive airway pressure: case report and literature review. Ochsner J. 2016;16(2):146-9.
21. Kanazawa H, Yoshida N, Yamamoto H, Hara M, Hasegawa M, Matsuzawa S, et al. Risk factors associated with severity of eosinophilic otitis media. Auris Nasus Larynx. 2014;41(6):513-7.
IssueVol 25 No 4 (2016) QRcode
SectionResearch Article(s)
Eustachian tube dysfunction inflation-deflation test obesity obstructive

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How to Cite
Adel Ghahraman M, Samimi Ardestani SH, Sadeghniiat Haghighi K. Eustachian tube dysfunction in patients with severe sleep disordered breathing: evidence from inflation-deflation test. Aud Vestib Res. 25(4):215-220.