title: Eustachian tube evaluation in aviators.
abstract: The aim of the study is to evaluate the Eustachian tube functionality in a group of aviators to underline a subclinical dysfunction and the related risk of ear fullness or barotitis. Hypobaric chamber allows to simulate the pressure variation of the flight. This prospective study enrolled 42 aviation pilots, members of the Italian Air Force, to whom were evaluated Eustachian tube functionality by Tubomanometry, patients subjective assessments concerning feasibility of Valsalva's and Toynbee's clinical symptoms, tympanometry, and objective Valsalva before and after exposure to hypobaric chamber. The new Eustachian tube score (ETS-7) was also calculated for each pilot before and after exposure to hypobaric chamber. Results of our examination showed that: before chamber exposition, in 92.8 % of pilots, an ETS-7 of eight or more was found bilaterally. In three (7.2 %) cases, a unilateral ETS-7 ≤ 7 was found and two of those had a positive history. After undergoing the hypobaric chamber session, the evaluation of ETS-7 showed only 19 % of pilots with an ETD score ≤7, in particular three bilateral and five unilateral cases. Three of those pilots were clinically positive: two airmen reported persistent fullness, while the other one had a barotitis. Therefore, the combined use of TMM and ETS-7 before and after hypobaric chamber exposure appears to be a reliable method for assessing the functional capacity of the Eustachian tube in aviators, the stressful effect of flight on it, to exclude subjects at increased risk of ear pain, fullness, or barotrauma.
authors.affiliation: 'Organi di Senso' Department, 'Sapienza' University of Rome, Viale del Policlinico, 151, 00161, Rome, Italy.
authors.forename: Giannicola
authors.initials: G
authors.lastname: Iannella
authors.affiliation: Aerospace Medicine Department, Experimental Flight Centre, Italian Air Force Logistic Command, Aeroporto di Pratica di Mare, Pomezia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lucertini
authors.affiliation: 'Organi di Senso' Department, 'Sapienza' University of Rome, Viale del Policlinico, 151, 00161, Rome, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Pasquariello
authors.affiliation: 'Organi di Senso' Department, 'Sapienza' University of Rome, Viale del Policlinico, 151, 00161, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manno
authors.affiliation: 'Organi di Senso' Department, 'Sapienza' University of Rome, Viale del Policlinico, 151, 00161, Rome, Italy.
authors.forename: Diletta
authors.initials: D
authors.lastname: Angeletti
authors.affiliation: Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Re
authors.affiliation: 'Organi di Senso' Department, 'Sapienza' University of Rome, Viale del Policlinico, 151, 00161, Rome, Italy. giuseppemagliuloorl@yahoo.com.|, Via Gregorio VII n. 80, 00165, Rome, Italy. giuseppemagliuloorl@yahoo.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Magliulo
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D001469:Barotrauma / Q000503:physiopathology*; D004427:Ear Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D000070356:Pilots; D011312:Pressure; D011446:Prospective Studies; D055815:Young Adult
keywords: Aviation; Eustachian tube dysfunction; Eustachian tube evaluation; Eustachian tube score; Tubomanometry