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Nasal Packing이 이관기능에 미치는 영향에 관한 연구
Published Online: May 31, 2020
Abstract
The function of the Eustachian tube is the maintenance of equal middle ear and atmospheric pressure by intermittent tubal opening. In addition, the Eustachian tube acts as a conduit for the removal of middle ear and mastoid secretion into the nasopharynx. The presence of a foreign body in the nasopharynx causes dysfunction of the Eustachian tube and alteration in middle ear pressure.
Authors studied effects of nasal packing on the Eustachian tube function using tympanometry. 100 patients undergoing surgery to the nasal septum followed by bilateral packing had pre-and post-operative tympanometry in order to determine the effect on Eustachian tube function.
The results were as follows;
47 of the 100 patients exhibited no significant change in middle ear pressure in either ear following the septal surgery and nasal packing.
18 patients developed a unilateral C pattern tympanogram following surgery with nasal packing in situ. Of these, 12 patients reverted to a normal A type tympanogram 24 hours after packing removal and 6 patients remained type C.
35 patients developed bilateral type C tympanogram following surgery with nasal packing in situ. Of these, 19 patients became normal on both sides by the following day after packing removal, 9 patients became normal on one side only and 7 patients remained with a bilateral C type tympanogram pattern.
Repeated testing at four weeks demonstrated a return to normal in all cases.
The change of middle ear pressure was -27.8mmH2O in preoperative day，-113.5mmH2O in 2nd postoperative day before packing removal，-75.5mmH2O in 3rd postoperative day after packing removal(24 hours following removal of the nasal packing), and nearly normalized -39.2mmH2O in 4 weeks after operation.