title: Site of eustachian tube obstruction in chronic ear disease.
abstract: OBJECTIVE
  Assess the patency of the proximal and distal segments of the Eustachian tube in patients undergoing surgery for chronic ear disease.
  
  
  METHODS
  Case study with control group.
  
  
  METHODS
  All consecutive patients presenting for surgery for chronic ear disease in our practice over 14 months underwent preoperative Valsalva computed tomography (CT), and an attempt was made intraoperatively using angled rigid scopes to evaluate obstruction of the protympanic segment of the Eustachian tube. Endoscopic examination of the same segment in 19 cadaver ears served as a control group.
  
  
  RESULTS
  Preoperative Valsalva CT showed patency of the distal one-third of the Eustachian tube in 51 of 53 ears. Intraoperative endoscopy allowed visualization of the protympanic opening of the Eustachian tube in 31 of 53 ears; 21 of 31 ears showed obstruction of the protympanic opening of the Eustachian tube.
  
  
  CONCLUSIONS
  A clear obstruction was more likely to be present in the protympanic opening of the Eustachian tube in the patient population undergoing surgery for chronic ear disease than in the cadaver control group, and was equally likely to be present in the distal cartilaginous tube in patients as in the control population.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, American Hospital Dubai, Dubai, United Arab Emirates.
authors.forename: Muaaz
authors.initials: M
authors.lastname: Tarabichi
authors.affiliation: Department of Otolaryngology, American Hospital Dubai, Dubai, United Arab Emirates.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Najmi
mesh_terms: D000328:Adult; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery*; D002908:Chronic Disease; D004724:Endoscopy; D005064:Eustachian Tube / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D014057:Tomography, X-Ray Computed; D018058:Tympanic Membrane Perforation / Q000473:pathology / Q000601:surgery*
keywords: Eustachian tube dysfunction; cholesteatoma; surgery for chronic ear disease; tympanic perforation