title: Eustachian Tube Function in 6-Year-Old Children with and without a History of Middle Ear Disease.
abstract: OBJECTIVE
  To test the hypothesis that eustachian tube opening efficiency, measured as the fractional gradient equilibrated (FGE), is lower in 6-year-old children with no middle ear disease but a well-documented history of recurrent acute otitis media, as compared with children with a negative disease history (control).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  Bilateral eustachian tube function was evaluated in 44 healthy 6-year-old children (19 boys, 29 white). None had middle ear disease at the time of testing, but 23 had a history of recurrent acute otitis media. Twenty-one had no significant past otitis media. Eustachian tube function was measured with a pressure chamber protocol that established negative middle ear gauge pressures (referenced to the chamber pressure) and recorded that pressure before and after a swallow. FGE was calculated as the change in middle ear gauge pressure with swallowing divided by the preswallow pressure. Between-group comparisons of the preswallow pressures and FGEs were made with a 2-tailed Student's t test.
  
  
  RESULTS
  FGE was independent of the preswallow middle ear gauge pressure. For the 39 and 44 evaluable ears in the control and recurrent acute otitis media groups, the mean preswallow pressures were -194 daPa (95% confidence interval [95% CI] = -211 to -177) versus -203 (95% CI = -216 to -190; P > .40), and FGEs were 0.32 (95% CI = 0.21-0.43) vs 0.16 (95% CI = 0.08-0.24; P = .016), respectively.
  
  
  CONCLUSIONS
  In children with past recurrent acute otitis media, residual eustachian tube opening inefficiency is maintained after they have "outgrown" their middle ear disease.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA mandele@pitt.edu.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mandel
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA.
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Richert
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Miriam S
authors.initials: MS
authors.lastname: Teixeira
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Swarts
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Doyle
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010034:Otitis Media with Effusion / Q000503:physiopathology*; D012008:Recurrence
keywords: eustachian tube; eustachian tube function; otitis; otitis media; pressure chamber