title: The forced-response test does not discriminate ears with different otitis media expressions.
abstract: OBJECTIVE
  Test the hypothesis that the eustachian tube (ET) function measured using standard manometric test methods is different between groups of ears with tympanostomy tubes inserted for recurrent acute otitis media (RAOM) and for chronic otitis media with effusion (COME).
  
  
  METHODS
  A cross-sectional study of ET function in populations of young children with different otitis media expressions.
  
  
  METHODS
  The results for forced-response testing of ET function were compared using a general linear model between 37 ears of 26 children and 34 ears of 26 children, aged 3 and 4 years, with ventilation tubes inserted for COME and RAOM, respectively.
  
  
  RESULTS
  There were no significant between-group differences in either the active measure of ET opening function, dilatory efficiency, or in the passive measures reflecting the magnitude of the forces that tend to hold the ET lumen closed, the opening and closing pressures, and passive trans-ET conductance.
  
  
  CONCLUSIONS
  The results do not support the hypothesis that ET closing forces are less in ears with RAOM when compared to ears with COME, and from the results of earlier studies, ears without disease. Both groups were characterized by a low ET opening efficiency (referenced to ears of adults with no disease history). Because both disease expressions present the same pattern of ET dysfunction, other factors are required to explain why a subset of ears with that type of dysfunction develop RAOM, as opposed to the default expression of COME.
  
  
  METHODS
  2b
authors.affiliation: Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mandel
authors.forename: James T
authors.initials: JT
authors.lastname: Seroky
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Swarts
authors.forename: William J
authors.initials: WJ
authors.lastname: Doyle
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005064:Eustachian Tube / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008365:Manometry / Q000379:methods; D008876:Middle Ear Ventilation / Q000379:methods*; D010033:Otitis Media / Q000175:diagnosis / Q000601:surgery; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000601:surgery*; D038781:Otoscopy / Q000379:methods*; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Eustachian tube; chronic otitis media with effusion; function tests; recurrent acute otitis media