title: Eustachian tube function and habitual sniffing in middle ear cholesteatoma.
abstract: OBJECTIVE
  To investigate the incidence of habitual sniffing and the function of eustachian tube in middle ear cholesteatoma.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred thirteen consecutive cases of primary acquired cholesteatoma were operated on from July 2005 to December 2007, and they consisted of 78 pars flaccida type (69.9%), 25 pars tensa type (22.1%), and 10 unclassified large type (8.8%). As a comparison, 178 consecutive cases of chronic otitis media (COM) and 30 consecutive cases of otosclerosis were also examined.
  
  
  METHODS
  A questionnaire was administered regarding symptoms of patulous tube and habitual sniffing to alleviate ear symptoms. Eustachian tube function was examined by sonotubometry.
  
  
  RESULTS
  The eustachian tube function in cholesteatoma showed patulous type (25.7%), stenotic type (44.2%), and normal type (30.1%), whereas that in COM showed 11.2%, 25.3%, and 63.5%, respectively, and that in otosclerosis showed 6.7%, 16.6%, and 76.7%, respectively. The incidence of patulous type is significantly higher in cholesteatoma than in COM (p < 0.01) and in otosclerosis (p < 0.05). Habitual sniffing was found to be significantly higher in cholesteatoma (31/113, 27.4%) than in COM (9/178, 5.1%) (p < 0.001) and in otosclerosis (1/30, 3.3%) (p < 0.001). The existence of diseases on the contralateral side was significantly higher in cases with habitual sniffing (26/31, 83.9%) than in those without habitual sniffing (32/82, 39.0%) (p < 0.001). After the canal wall up method, postoperative retraction of the eardrum is significantly related to habitual sniffing continuing after the surgery.
  
  
  CONCLUSIONS
  Patulous eustachian tube and habitual sniffing may play a role for pathogenesis of middle ear cholesteatoma.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ohta
authors.forename: Masafumi
authors.initials: M
authors.lastname: Sakagami
authors.forename: Mikio
authors.initials: M
authors.lastname: Suzuki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Mishiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000503:physiopathology*; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000503:physiopathology / Q000601:surgery; D010040:Otosclerosis / Q000503:physiopathology; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000209:etiology*; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000503:physiopathology / Q000601:surgery; D014433:Tympanoplasty; D055815:Young Adult