Skip to main content
Erschienen in: HNO 8/2017

05.12.2016 | Tubenfunktionsstörung | Übersichten

Druckausgleichende Funktion der Eustachischen Röhre

Evaluation in einer hypo-/hyperbaren Druckkammer

verfasst von: Dr. med. S. Jansen, M. F. Meyer, K.-B. Hüttenbrink, D. Beutner

Erschienen in: HNO | Ausgabe 8/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Die Eustachische Röhre bildet eine Verbindung zwischen der Paukenhöhle (Cavum tympani) und dem Nasenrachen (Nasopharynx), über die ein Druckausgleich zwischen Mittelohr und Umgebungsdruck möglich ist. Insbesondere beim Tauchen und Fliegen ist ein funktionierender Druckausgleich aufgrund von ungewohnt großen Druckdifferenzen nötig.

Fragestellung

Die Überprüfung der druckausgleichenden Tubenfunktion ist weiterhin eine klinisch-wissenschaftliche Herausforderung. Dieser Übersichtsartikel evaluiert die vorhandene Datenlage.

Methoden

Verschiedene Methoden zur Überprüfung der Tubenfunktion werden nach Literaturrecherche unter besonderer Berücksichtigung der Evaluation der druckausgleichenden Tubenfunktion in einer hypo-/hyperbaren Druckkammer vorgestellt und bewertet.

Ergebnisse

Mit der Druckkammer steht ein Diagnostikum zur Verfügung, das einerseits die Dynamik der Tubenfunktion im aktiven und passiven Druckausgleich provoziert und andererseits eine genaue Messung der Drücke im Millibarbereich ermöglicht.

Schlussfolgerung

Die Untersuchung der Funktion der Eustachischen Röhre in einer Druckkammer scheint aufgrund der vorliegenden Datenlage geeignet, um Therapien der Tubendysfunktion zu beurteilen. Weitere Studien sind notwendig, um den Stellenwert der Druckkammer in Zusammenschau mit anderen Funktionsprüfungen zu evaluieren.
Literatur
1.
Zurück zum Zitat Feldmann H (1973) Physiology and physiopathology of middle ear ventilation. I. Middle ear volume and its gas content. Physiology of the eustachian tube. Z Laryngol Rhinol Otol 52(7):471–485PubMed Feldmann H (1973) Physiology and physiopathology of middle ear ventilation. I. Middle ear volume and its gas content. Physiology of the eustachian tube. Z Laryngol Rhinol Otol 52(7):471–485PubMed
2.
Zurück zum Zitat Leuwer R, Schubert R, Kucinski T, Liebig T, Maier H (2002) The muscular compliance of the auditory tube: a model-based survey. Laryngoscope 112(10):1791–1795CrossRefPubMed Leuwer R, Schubert R, Kucinski T, Liebig T, Maier H (2002) The muscular compliance of the auditory tube: a model-based survey. Laryngoscope 112(10):1791–1795CrossRefPubMed
3.
Zurück zum Zitat Seibert JW, Danner CJ (2006) Eustachian tube function and the middle ear. Otolaryngol Clin North Am 39(6):1221–1235CrossRefPubMed Seibert JW, Danner CJ (2006) Eustachian tube function and the middle ear. Otolaryngol Clin North Am 39(6):1221–1235CrossRefPubMed
4.
Zurück zum Zitat Bluestone CD (2008) Impact of evolution on the eustachian tube. Laryngoscope 118(3):522–527CrossRefPubMed Bluestone CD (2008) Impact of evolution on the eustachian tube. Laryngoscope 118(3):522–527CrossRefPubMed
5.
Zurück zum Zitat Feldmann H (1973) Physiology and pathophysiology of the ventilation of the middle ear. 2. Methods of examination of the eustachian tube. Pathophysiology of typical ventilation disorders of the middle ear. Z Laryngol Rhinol Otol 52(8):555–572PubMed Feldmann H (1973) Physiology and pathophysiology of the ventilation of the middle ear. 2. Methods of examination of the eustachian tube. Pathophysiology of typical ventilation disorders of the middle ear. Z Laryngol Rhinol Otol 52(8):555–572PubMed
6.
Zurück zum Zitat Bernstein JM (2002) Immunologic aspects of otitis media. Curr Allergy Asthma Rep 2(4):309–315CrossRefPubMed Bernstein JM (2002) Immunologic aspects of otitis media. Curr Allergy Asthma Rep 2(4):309–315CrossRefPubMed
9.
Zurück zum Zitat Bluestone CD, Hebda PA, Alper CM, Sando I, Buchman CA, Stangerup SE, Felding JU, Swarts JD, Ghadiali SN, Takahashi H (2005) Recent advances in otitis media. 2. Eustachian tube, middle ear, and mastoid anatomy; physiology, pathophysiology, and pathogenesis. Ann Otol Rhinol Laryngol Suppl 194:16–30CrossRefPubMed Bluestone CD, Hebda PA, Alper CM, Sando I, Buchman CA, Stangerup SE, Felding JU, Swarts JD, Ghadiali SN, Takahashi H (2005) Recent advances in otitis media. 2. Eustachian tube, middle ear, and mastoid anatomy; physiology, pathophysiology, and pathogenesis. Ann Otol Rhinol Laryngol Suppl 194:16–30CrossRefPubMed
11.
Zurück zum Zitat Dalchow CV, Loewenthal M, Kappo N, Jenckel F, Loerincz BB, Knecht R (2015) First results of Endonasal dilatation of the Eustachian tube (EET) in patients with chronic obstructive tube dysfunction. Eur Arch Otorhinolaryngol 273(3):607–613. doi:10.1007/s00405-015-3602-0 CrossRefPubMed Dalchow CV, Loewenthal M, Kappo N, Jenckel F, Loerincz BB, Knecht R (2015) First results of Endonasal dilatation of the Eustachian tube (EET) in patients with chronic obstructive tube dysfunction. Eur Arch Otorhinolaryngol 273(3):607–613. doi:10.​1007/​s00405-015-3602-0 CrossRefPubMed
12.
Zurück zum Zitat Poe DS, Hanna BM (2011) Balloon dilation of the cartilaginous portion of the eustachian tube: initial safety and feasibility analysis in a cadaver model. Am J Otolaryngol 32(2):115–123CrossRefPubMed Poe DS, Hanna BM (2011) Balloon dilation of the cartilaginous portion of the eustachian tube: initial safety and feasibility analysis in a cadaver model. Am J Otolaryngol 32(2):115–123CrossRefPubMed
13.
Zurück zum Zitat Tarabichi M, Najmi M (2015) Transtympanic dilatation of the eustachian tube during chronic ear surgery. Acta Otolaryngol 135(7):640–644CrossRefPubMed Tarabichi M, Najmi M (2015) Transtympanic dilatation of the eustachian tube during chronic ear surgery. Acta Otolaryngol 135(7):640–644CrossRefPubMed
14.
Zurück zum Zitat Pau HW (2015) Does balloon dilatation represent a breakthrough for Eustachian tube disorders – even in children? HNO 63(10):681–685CrossRefPubMed Pau HW (2015) Does balloon dilatation represent a breakthrough for Eustachian tube disorders – even in children? HNO 63(10):681–685CrossRefPubMed
15.
Zurück zum Zitat Sudhoff H, Schroder S, Reineke U, Lehmann M, Korbmacher D, Ebmeyer J (2013) Therapy of chronic obstructive eustachian tube dysfunction: evolution of applied therapies. HNO 61(6):477–482CrossRefPubMed Sudhoff H, Schroder S, Reineke U, Lehmann M, Korbmacher D, Ebmeyer J (2013) Therapy of chronic obstructive eustachian tube dysfunction: evolution of applied therapies. HNO 61(6):477–482CrossRefPubMed
16.
Zurück zum Zitat McLellan TM, Wright HE, Rhind SG, Cameron BA, Eaton DJ (2010) Hyperbaric stress in divers and non-divers: neuroendocrine and psychomotor responses. Undersea Hyperb Med 37(4):219–231PubMed McLellan TM, Wright HE, Rhind SG, Cameron BA, Eaton DJ (2010) Hyperbaric stress in divers and non-divers: neuroendocrine and psychomotor responses. Undersea Hyperb Med 37(4):219–231PubMed
17.
Zurück zum Zitat Strohm M (1986) Trauma of the middle ear. Clinical findings, postmortem observations and results of experimental studies. Adv Otorhinolaryngol 35:1–254PubMed Strohm M (1986) Trauma of the middle ear. Clinical findings, postmortem observations and results of experimental studies. Adv Otorhinolaryngol 35:1–254PubMed
18.
Zurück zum Zitat Azizi MH (2011) Ear disorders in scuba divers. Int J Occup Environ Med 2(1):20–26PubMed Azizi MH (2011) Ear disorders in scuba divers. Int J Occup Environ Med 2(1):20–26PubMed
19.
Zurück zum Zitat Monsell EM, Harley RE (1996) Eustachian tube dysfunction. Otolaryngol Clin North Am 29(3):437–444PubMed Monsell EM, Harley RE (1996) Eustachian tube dysfunction. Otolaryngol Clin North Am 29(3):437–444PubMed
20.
21.
Zurück zum Zitat Martino E, Di Thaden R, Krombach GA, Westhofen M (2004) Function tests for the Eustachian tube. Current knowledge. HNO 52(11):1029–1039 (quiz 1040)CrossRefPubMed Martino E, Di Thaden R, Krombach GA, Westhofen M (2004) Function tests for the Eustachian tube. Current knowledge. HNO 52(11):1029–1039 (quiz 1040)CrossRefPubMed
22.
Zurück zum Zitat Schroder S, Lehmann M, Korbmacher D, Sauzet O, Sudhoff H, Ebmeyer J (2015) Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction. Clin Otolaryngol 40(6):691–697. doi:10.1111/coa.12451 CrossRefPubMed Schroder S, Lehmann M, Korbmacher D, Sauzet O, Sudhoff H, Ebmeyer J (2015) Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction. Clin Otolaryngol 40(6):691–697. doi:10.​1111/​coa.​12451 CrossRefPubMed
23.
Zurück zum Zitat Sudhoff H, Ockermann T, Mikolajczyk R, Ebmeyer J, Korbmacher D, Garten D, Schreiber S (2009) Clinical and experimental considerations for evaluation of Eustachian tube physiology. HNO 57(5):428–435CrossRefPubMed Sudhoff H, Ockermann T, Mikolajczyk R, Ebmeyer J, Korbmacher D, Garten D, Schreiber S (2009) Clinical and experimental considerations for evaluation of Eustachian tube physiology. HNO 57(5):428–435CrossRefPubMed
24.
Zurück zum Zitat Borangiu A, Popescu CR, Purcarea VL (2014) Sonotubometry, a useful tool for the evaluation of the Eustachian tube ventilatory function. J Med Life 7(4):604–610PubMedPubMedCentral Borangiu A, Popescu CR, Purcarea VL (2014) Sonotubometry, a useful tool for the evaluation of the Eustachian tube ventilatory function. J Med Life 7(4):604–610PubMedPubMedCentral
25.
Zurück zum Zitat van der Avoort SJ, van Heerbeek N, Zielhuis GA, Cremers CW (2005) Sonotubometry: eustachian tube ventilatory function test: a state-of-the-art review. Otol Neurotol 26(3):538–543 (discussion 543)CrossRefPubMed van der Avoort SJ, van Heerbeek N, Zielhuis GA, Cremers CW (2005) Sonotubometry: eustachian tube ventilatory function test: a state-of-the-art review. Otol Neurotol 26(3):538–543 (discussion 543)CrossRefPubMed
26.
Zurück zum Zitat Asenov DR, Nath V, Telle A, Antweiler C, Walther LE, Vary P, Di Martino EF (2010) Sonotubometry with perfect sequences: first results in pathological ears. Acta Otolaryngol 130(11):1242–1248CrossRefPubMed Asenov DR, Nath V, Telle A, Antweiler C, Walther LE, Vary P, Di Martino EF (2010) Sonotubometry with perfect sequences: first results in pathological ears. Acta Otolaryngol 130(11):1242–1248CrossRefPubMed
27.
Zurück zum Zitat Poe DS, Abou-Halawa A, Abdel-Razek O (2001) Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 22(5):590–595CrossRefPubMed Poe DS, Abou-Halawa A, Abdel-Razek O (2001) Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 22(5):590–595CrossRefPubMed
28.
Zurück zum Zitat Van Roeyen S, Van de Heyning P, Van Rompaey V (2015) Value and discriminative power of the seven-item eustachian tube dysfunction questionnaire. Laryngoscope 125(11):2553–2556. doi:10.1002/lary.25316 CrossRefPubMed Van Roeyen S, Van de Heyning P, Van Rompaey V (2015) Value and discriminative power of the seven-item eustachian tube dysfunction questionnaire. Laryngoscope 125(11):2553–2556. doi:10.​1002/​lary.​25316 CrossRefPubMed
29.
Zurück zum Zitat Schroder S, Lehmann M, Sauzet O, Ebmeyer J, Sudhoff H (2015) A novel diagnostic tool for chronic obstructive eustachian tube dysfunction-the eustachian tube score. Laryngoscope 125(3):703–708CrossRefPubMed Schroder S, Lehmann M, Sauzet O, Ebmeyer J, Sudhoff H (2015) A novel diagnostic tool for chronic obstructive eustachian tube dysfunction-the eustachian tube score. Laryngoscope 125(3):703–708CrossRefPubMed
30.
Zurück zum Zitat Gaihede M, Padurariu S, Jacobsen H, De Greef D, Dirckx JJ (2013) Eustachian tube pressure equilibration. Temporal analysis of pressure changes based on direct physiological recordings with an intact tympanic membrane. Hear Res 301:53–59CrossRefPubMed Gaihede M, Padurariu S, Jacobsen H, De Greef D, Dirckx JJ (2013) Eustachian tube pressure equilibration. Temporal analysis of pressure changes based on direct physiological recordings with an intact tympanic membrane. Hear Res 301:53–59CrossRefPubMed
32.
Zurück zum Zitat Thomsen KA (1958) Investigations on the tubal function and measurement of the middle ear pressure in pressure chamber. Acta Otolaryngol Suppl 140:269–278CrossRefPubMed Thomsen KA (1958) Investigations on the tubal function and measurement of the middle ear pressure in pressure chamber. Acta Otolaryngol Suppl 140:269–278CrossRefPubMed
33.
Zurück zum Zitat Ingelstedt S, Ivarsson, Jonson B (1967) Mechanics of the human middle ear. Pressure regulation in aviation and diving. A non-traumatic method. Acta Otolaryngol Suppl 228:221–258 Ingelstedt S, Ivarsson, Jonson B (1967) Mechanics of the human middle ear. Pressure regulation in aviation and diving. A non-traumatic method. Acta Otolaryngol Suppl 228:221–258
34.
Zurück zum Zitat Elner A, Ingelstedt S, Ivarsson A (1971) The normal function of the eustachian tube. A study of 102 cases. Acta Otolaryngol 72(5):320–328CrossRefPubMed Elner A, Ingelstedt S, Ivarsson A (1971) The normal function of the eustachian tube. A study of 102 cases. Acta Otolaryngol 72(5):320–328CrossRefPubMed
35.
Zurück zum Zitat Munker G, Pedersen P, Grundmann S (1972) Eustachian tube function test in a hyperbaric chamber: registration using a differential manometer. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 201(3):249–257CrossRefPubMed Munker G, Pedersen P, Grundmann S (1972) Eustachian tube function test in a hyperbaric chamber: registration using a differential manometer. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 201(3):249–257CrossRefPubMed
36.
Zurück zum Zitat Mewes T, Mann W (1998) Function of the eustachian tube in epitympanic retraction pockets. HNO 46(11):914–918CrossRefPubMed Mewes T, Mann W (1998) Function of the eustachian tube in epitympanic retraction pockets. HNO 46(11):914–918CrossRefPubMed
37.
Zurück zum Zitat Jumah MD, Schlachta M, Hoelzl M, Werner A, Sedlmaier B (2010) Pressure regulating ear plug testing in a pressure chamber. Aviat Space Environ Med 81(6):560–565CrossRefPubMed Jumah MD, Schlachta M, Hoelzl M, Werner A, Sedlmaier B (2010) Pressure regulating ear plug testing in a pressure chamber. Aviat Space Environ Med 81(6):560–565CrossRefPubMed
38.
Zurück zum Zitat Mikolajczak S, Meyer MF, Hahn M, Korthauer C, Jumah MD, Huttenbrink KB, Grosheva M, Luers JC, Beutner D (2015) Characterizing the active opening of the eustachian tube in a hypobaric/hyperbaric pressure chamber. Otol Neurotol 36(1):70–75PubMed Mikolajczak S, Meyer MF, Hahn M, Korthauer C, Jumah MD, Huttenbrink KB, Grosheva M, Luers JC, Beutner D (2015) Characterizing the active opening of the eustachian tube in a hypobaric/hyperbaric pressure chamber. Otol Neurotol 36(1):70–75PubMed
39.
Zurück zum Zitat Meyer MF, Mikolajczak S, Luers JC, Lotfipour S, Beutner D, Jumah MD (2013) Characterizing the passive opening of the Eustachian tube in a hypo-/hyperbaric pressure chamber. Laryngorhinootologie. doi:10.1055/s-0033-1351292 Meyer MF, Mikolajczak S, Luers JC, Lotfipour S, Beutner D, Jumah MD (2013) Characterizing the passive opening of the Eustachian tube in a hypo-/hyperbaric pressure chamber. Laryngorhinootologie. doi:10.​1055/​s-0033-1351292
40.
Zurück zum Zitat Meyer MF, Mikolajczak S, Korthauer C, Jumah MD, Hahn M, Grosheva M, Luers JC, Huttenbrink KB, Beutner D (2015) Impact of xylomethazoline on eustachian tube function in healthy participants. Otol Neurotol 36(5):769–775CrossRefPubMed Meyer MF, Mikolajczak S, Korthauer C, Jumah MD, Hahn M, Grosheva M, Luers JC, Huttenbrink KB, Beutner D (2015) Impact of xylomethazoline on eustachian tube function in healthy participants. Otol Neurotol 36(5):769–775CrossRefPubMed
41.
Zurück zum Zitat Doyle WJ, Singla A, Banks J, El-Wagaa J, Swarts JD (2014) Pressure chamber tests of eustachian tube function document lower efficiency in adults with colds when compared to without colds. Acta Otolaryngol 134(7):691–697CrossRefPubMed Doyle WJ, Singla A, Banks J, El-Wagaa J, Swarts JD (2014) Pressure chamber tests of eustachian tube function document lower efficiency in adults with colds when compared to without colds. Acta Otolaryngol 134(7):691–697CrossRefPubMed
42.
Zurück zum Zitat Swarts JD, Casselbrant ML, Teixeira MS, Mandel EM, Richert BC, Banks JM, El-Wagaa J, Doyle WJ (2014) Eustachian tube function in young children without a history of otitis media evaluated using a pressure chamber protocol. Acta Otolaryngol 134(6):579–587CrossRefPubMedPubMedCentral Swarts JD, Casselbrant ML, Teixeira MS, Mandel EM, Richert BC, Banks JM, El-Wagaa J, Doyle WJ (2014) Eustachian tube function in young children without a history of otitis media evaluated using a pressure chamber protocol. Acta Otolaryngol 134(6):579–587CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Fischer HG, Koch A, Kahler W, Pohl M, Pau HW, Zehlicke T (2016) The measurement of Eustachian tube function in a hyperbaric chamber using an ear canal microphone. Diving Hyperb Med 46(1):33–37PubMed Fischer HG, Koch A, Kahler W, Pohl M, Pau HW, Zehlicke T (2016) The measurement of Eustachian tube function in a hyperbaric chamber using an ear canal microphone. Diving Hyperb Med 46(1):33–37PubMed
44.
Zurück zum Zitat Swarts JD, Teixeira MS, Banks J, El-Wagaa J, Doyle WJ (2015) A method to assess the accuracy of sonotubometry for detecting Eustachian tube openings. Eur Arch Otorhinolaryngol 272(9):2111–2119CrossRefPubMed Swarts JD, Teixeira MS, Banks J, El-Wagaa J, Doyle WJ (2015) A method to assess the accuracy of sonotubometry for detecting Eustachian tube openings. Eur Arch Otorhinolaryngol 272(9):2111–2119CrossRefPubMed
45.
Zurück zum Zitat Jumah MD, Jumah M, Pazen D, Sedlmaier B (2012) Laser Eustachian tuboplasty: efficiency evaluation in the pressure chamber. Otol Neurotol 33(3):406–412CrossRefPubMed Jumah MD, Jumah M, Pazen D, Sedlmaier B (2012) Laser Eustachian tuboplasty: efficiency evaluation in the pressure chamber. Otol Neurotol 33(3):406–412CrossRefPubMed
Metadaten
Titel
Druckausgleichende Funktion der Eustachischen Röhre
Evaluation in einer hypo-/hyperbaren Druckkammer
verfasst von
Dr. med. S. Jansen
M. F. Meyer
K.-B. Hüttenbrink
D. Beutner
Publikationsdatum
05.12.2016
Verlag
Springer Medizin
Erschienen in
HNO / Ausgabe 8/2017
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-016-0293-9

Weitere Artikel der Ausgabe 8/2017

HNO 8/2017 Zur Ausgabe

Repetitorium Facharztprüfung

Warum schmerzte es beim Schlucken?

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.