[Video endoscopic analysis of eustachian tube function in children with middle ear pathology]

Evaluation of Eustachian Tube Function in Cases of Chronic Otitis Media by Dynamic Slow Motion Videoendoscopy and Impedance Audiometry

Eustachian tube (ET) dysfunction is known to be a cause for various middle ear diseases. Dynamic slow motion videoendoscopy (DSVE) and impedance audiometry (IA) can both be employed to evaluate ET dysfunction. To assess the role of DSVE and IA for diagnosing ET dysfunction in cases of middle ear disorders. It is a prospective case control study. 102 ears with chronic otitis media were taken as cases and 102 healthy ears as controls. IA and DSVE were performed to assess ET function in both the groups. Sensitivity/ specificity of both the diagnostic tests were evaluated in case and control groups. Out of 102 ET of case group exposed to both tests, 87 were found to have ET dysfunction by DSVE and 80 by IA. Among 102 ET of control group 78 were identified as normal by DSVE while 87 by IA. On applying chi square test in both these groups, the associations were significant. (p value < 0.0001). Patients with grade 2B or higher on DSVE endoscopy had abnormal IA findings, indicating that higher the grade on DSVE, higher the chance of abnormal IA. DSVE and IA are potentially useful tools in evaluation of cases of COM and which provide information regarding functional and pathological factors responsible for ET dysfunction.

[Mini-endoscopy in the head and neck region]

Minimally invasive, in particular endoscopic treatment modalities are an important topic in medicine today. Over the last 15 years mini-endoscopy (ME) has been introduced and established in different fields of the head and neck region. ME includes endoscopy of the Eustachian tube, middle ear, lacrimal duct system and duct system of the major salivary glands. Direct visualization by endoscopy enables rapid, efficient and accurate diagnosis and treatment planning according to the findings. In the majority of cases simultaneous interventional therapy is possible. This has lead to a fundamental change in treatment regimes which now aim to preserve the anatomic structure and function. In specialized centers the frequency of external dacryocystostomy could be reduced to less than 10% by means of endoscopic surgery of the lacrimal system, while the frequency of parotidectomy was reduced to below 5%. This development allows not only for medical advances, but also for the desired cost reduction on the part of the administrative organs responsible for providing medical care.