Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation

• Published in: Journal of laryngology and otology 2017-09, Vol.131 (9), p.817-822
• Main Authors: Ilan, O, Marcus, E-L, Cohen, Y, Farkash, T, Levy, R, Sasson, A, Adelman, C
• Format: Article
• Language: English
• Subjects: Acoustic Impedance Tests; Adult; Adults; Aged; Aged, 80 and over; Cognition & reasoning; Cognitive ability; Consciousness; Ear; Ear diseases; Ear Diseases - epidemiology; Ear Diseases - physiopathology; Ear, Middle - physiopathology; Ears & hearing; Eustachian Tube - physiopathology; Female; Hearing loss; Humans; Intensive care; Intubation; Main Articles; Male; Mechanical ventilation; Middle Aged; Ostomy; Otolaryngology; Pathology; Prospective Studies; Respiration, Artificial - adverse effects; Risk factors; Studies; Tracheostomy; Ventilators; Young Adult
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215117001554

This study aimed to investigate the prevalence of and risk factors for Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation via tracheostomy tube. A total of 40 patients on chronic ventilation were included in a prospective cohort study. Middle-ear status was determined by tympanometry. Tympanograms were categorised as types A, B or C; types B and C were defined as middle-ear pathology. In all, 57 ears of 40 patients were examined. Disease was found in at least 1 ear in 26 out of 40 patients. Middle-ear pathology was found in 25 out of 34 patients who were tube fed (via nasogastric tube or percutaneous endoscopic gastrostomy) vs 1 patient out of the 6 fed orally (p = 0.014), and in 23 out of 31 with conscious or cognitive impairment vs 3 out of 9 cognitively intact patients (p = 0.044). Middle-ear pathology is common in patients on chronic mechanical ventilation via tracheostomy tube. The highest prevalence was in those with impaired consciousness or cognition, and oral feeding appeared protective.