Using Geometric Morphometric Analysis of Magnetic Resonance Imaging to Assess the Anatomy of the Eustachian Tube in Children with and without Otitis Media.

Otitis media (OM) is among the most common of childhood illnesses. It has long been hypothesized that children under age two are predisposed to OM due to differences in the anatomy of the Eustachian tube (ET), including the angle of the ET. OM in later childhood is less common but does occur, begging the question, are there shape differences in the ET that persist underlying later occurrences of OM? To answer this question, a novel method, which applied geometric and morphometric shape analysis to landmarks obtained from MRI data, was used.

CT Imaging of Eustachian Tube Balloon Dilation: Method Development on Cadaver Heads.

: To develop a methodology for the measurement of balloon dilation (BD) effects on Eustachian Tube (ET) structure using Computerized Tomography (CT) images. : The BD of the ET was performed on three cadaver heads (five ears) through the nasopharyngeal orifice. The axial CT images of the temporal bones were obtained before dilation, while an inflated balloon was in the lumen of ET, and after balloon removal in each ear.

Tubomanometry in measurement of velopharyngeal closure: A pilot study.

Objective: To investigate the differences in velum closure pattern in people with and without a history of middle ear disease using intranasal pressure curves recorded with the tubomanometer, a Eustachian tube (ET) testing device.

Study Design: Case control study.

Setting: Tertiary referral center.

Dissecting eustachian tube dysfunction: From phenotypes to endotypes.

Objective: A broad spectrum of complaints, symptoms and manifestations has been assigned to Eustachian tube (ET) dysfunction (ETD). While such presentations may manifest as ETD phenotypes, underlying mechanisms are defined as endotypes. Our goal is to develop a diagnostic approach to differentiate the endotypes and guide clinicians in the workup and selection of treatments targeting the mechanism of ETD.

Change in Eustachian Tube Function With Balloon Dilation in Adults With Ventilation Tubes.

Objective: Assess the changes in Eustachian tube (ET) function (ETF) with balloon dilation of Eustachian tube (BDET).

Study Design: Prospective cohort for repeated testing measures.

Setting: Clinical research center.

Presentation and eustachian tube function test results in children evaluated at a specialty clinic.

Objectives/hypothesis: Interest in eustachian tube (ET) dysfunction (ETD) has increased with the recent Food and Drug Administration approval of a new device for balloon dilation of the ET (BDET) in adults. However, children have been receiving BDET treatment with ET-specific or sinus balloons around the world and off-label in the United States for years. It is important, therefore, to understand the manifestations of and methods to verify ETD in children.

Eustachian Tube Function in Adults with Ventilation Tubes Inserted for Otitis Media with Effusion.

Objective: To investigate the eustachian tube (ET) function (ETF) in adults with ventilation tube (VT) inserted for the treatment of chronic otitis media with effusion (COME).

Materials And Methods: A total of 17 subjects with at least one VT were enrolled. A detailed history was obtained, and risk factors were assessed with questionnaires.

A Novel Imaging Method for the Cartilaginous Eustachian Tube Lumen: Computerized Tomography During the Forced Response Test.

Objectives: In vivo imaging of the open cartilaginous Eustachian tube (ET) lumen by computed tomography (CT) scan during ET function (ETF) testing to establish new methodology.

Methods: Five adults underwent unilateral ETF testing of an ear with a nonintact tympanic membrane using the forced response test (FRT) to measure the opening pressure (PO), steady state pressure (PS), and flow conductance (CS). Then at baseline and during the PS phase of the FRT, a temporal-bone CT scan with continuous 0.

Accuracy of the ETDQ-7 for Identifying Persons with Eustachian Tube Dysfunction.

Objective To compare the accuracy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) in identifying people with eustachian tube (ET) dysfunction based on symptoms and an objective ET function test. Study Design Cross-sectional study. ObjSettingective Tertiary referral center.

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid-Anatomy, Physiology, Pathophysiology, and Pathogenesis).

Objective In this report, we review the recent literature (ie, past 4 years) to identify advances in our understanding of the middle ear-mastoid-eustachian tube system. We use this review to determine whether the short-term goals elaborated in the last report were achieved, and we propose updated goals to guide future otitis media research. Data Sources PubMed, Web of Science, Medline.

Quantitative representation of Eustachian tube component movements during swallowing.

Objective: Describes a method of dynamic video-endoscopy of the Eustachian tube (ET) orifice at the nasopharynx to quantitatively represent ET component movements during swallowing using a graphic function and analyze their importance to its opening mechanics.

Methods: This was a pilot study of relational event capture using a polar coordinate system applied to trans-nasal video-endoscopic recordings of the ET during 3 swallows in 5 adults. After topical anesthesia of the nose, a 45° telescope was introduced unilaterally and focused on the ipsilateral ET orifice.

Histamine Applied Topically to the Nasal Mucosa Increases the Transmucosal Nitrous Oxide Exchange for the Middle Ear.

Objective: Determine if the middle ear transmucosal nitrous oxide (NO) exchange rate is affected by nasal inflammation caused by topical application of histamine.

Methods: In a randomized, double-blind, crossover study, 20 adults were challenged intranasally with histamine (5 mg) and placebo on separate occasions. At each session, the subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes, 50% NO:50% O for 20 minutes, and 100% O for 10 minutes.

Diagnostic accuracy of tubomanometry R value in detecting the Eustachian tube pressure equalizing function.

Tubomanometry is a relatively novel Eustachian tube (ET) function testing method. A number of recent studies have utilized the R value of Tubomanometry as the main objective measure in reporting their outcome in balloon dilation of ET. There is, however, a lack of evidence concerning the reliability or validity of Tubomanometry measurements.

Correlations between videoendoscopy and sonotubometry of eustachian tube opening during a swallow.

Objectives/hypothesis: Describe the relationship between the magnitude of eustachian tube (ET) dilation during swallowing observed on transnasal videoendoscopy and quantified by sonotubometry.

Study Design: Descriptive observational study.

Methods: Simultaneous transnasal videoendoscopic and sonotubometric recordings were done on 33 adults with no middle ear disease.

Eustachian Tube Function in 6-Year-Old Children with and without a History of Middle Ear Disease.

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).

Study Design: Cross-sectional study.

Setting: Tertiary care pediatric hospital.

Oxymetazoline Applied Topically to the Nasal Mucosa Decreases Trans-Mucosal Nitrous Oxide Exchange for the Middle Ear.

Objective: Determine if the middle ear (ME) trans-mucosal nitrous oxide (N2O) gas exchange rate can be pharmacologically modulated by the nasal application of a vasoconstrictor.

Methods: In a randomized, double-blind, crossover study, 20 adults received a nasal spray challenge containing either oxymetazoline or saline (placebo). At each session, subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes, 50% N2O:50% O2 for 20 minutes, and 100% O2 for 10 minutes.

Oral pseudoephedrine decreases the rate of transmucosal nitrous oxide exchange for the middle ear.

Objectives/hypothesis: Determine if oral treatment with a vasoconstrictor decreases the blood to middle ear exchange rate of the perfusion-limited gas, nitrous oxide (N2O).

Study Design: Randomized, double-blind, crossover study.

Methods: Ten adult subjects with and 10 without past middle ear disease completed paired experimental sessions, identical except for oral treatment with either pseudoephedrine hydrochloride or lactose placebo.

Quantitative description of eustachian tube movements during swallowing as visualized by transnasal videoendoscopy.

Importance: Eustachian tube (ET) dysfunction predisposes ears to otitis media, tympanic membrane retraction, retraction pocket and perforation, or cholesteatoma.

Objective: To develop a method to quantitatively measure the eustachian tube (ET) component movements and their interactions captured by transnasal videoendoscopy of the ET during swallowing.

Design, Setting, And Participants: A blinded analysis of ET mechanics in 33 adults, aged 18 to 54 years, with no middle ear disease at present but without (group 1 [n = 16]) or with (group 2 [n = 17]) history of disease, conducted at a clinical research laboratory.

Eustachian tube function in young children without a history of otitis media evaluated using a pressure chamber protocol.

Conclusions: Protocol limitations were identified and accounted for in the analysis. Percent gradient equilibrated (PGE) was affected by driving gradient direction in a similar manner to other efficiency measures. A finer resolution of possible age-related changes in eustachian tube opening efficiency is expected with the application of more sophisticated statistical models to the complete dataset at study end.

A method to assess the accuracy of sonotubometry for detecting Eustachian tube openings.

Sonotubometry is a simple test for Eustachian tube (ET) opening during a maneuver. Different sonotubometry configurations were suggested to maximize test accuracy, but no method has been described for comparing sonotubometry test results with those for a definitive measure of ET opening. Here, we present such a method and exemplify is use by an accuracy assessment of a simple sonotubometry configuration.

Eustachian tube opening measured by sonotubometry is poorer in adults with a history of past middle ear disease.

Objective: Test the hypothesis that active Eustachian tube opening efficiency as measured by sonotubometry is higher in adults with no extant middle-ear disease and no history of previous otitis media (Group-1) when compared to adults with no middle-ear disease but a positive history for otitis media (Group-2).

Methods: Eustachian tube function for 1 ear of 33 otherwise healthy adult subjects, 16 assigned to Group-1 and 17 to Group-2, was tested by sonotubometry using a standard protocol. For each test, the sound envelopes for 3 swallows were abstracted independently by 2 observers from the data stream and 7 descriptive parameters related to sound envelope "shape" were calculated.

KLF6 allelic loss is associated with tumor recurrence and markedly decreased survival in head and neck squamous cell carcinoma.

The Krüppel-like transcription factor (KLF6) gene is a tumor suppressor gene (TSG) reported to be dysregulated and inactivated through loss of heterozygosity (LOH) and/or somatic mutation in a number of major human cancers. The aim of the present study was to examine KLF6 gene status and expression in head and neck squamous cell carcinomas (HNSCC). A collection of 81 well-characterized oral and oropharyngeal HNSCC samples were analyzed for evidence of KLF6 LOH and mutation and differences in expression patterns between normal and cancerous tissues and these findings were correlated with clinicopathological variables.

Differential expression of Ro/SSA 60 kDa and La/SSB, but not Ro/SSA 52 kDa, mRNA and protein in minor salivary glands from patients with primary Sjögren's syndrome.

Objective: To analyze the protein and messenger RNA (mRNA) expression of La/SSB, Ro/SSA 60, and Ro/SSA 52 antigens in minor salivary glands (MSG) from patients with primary Sjögren's syndrome (pSS).

Methods: La/SSB, Ro/SSA 60, and Ro/SSA 52 protein expression was studied by immunohistochemistry in MSG from 26 patients with pSS and 16 controls. mRNA expression was determined by real-time polymerase chain reaction in MSG of 10 patients with pSS and 7 controls.

Functional inactivation of the KLF6 tumor suppressor gene by loss of heterozygosity and increased alternative splicing in glioblastoma.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor and possesses a high incidence of 10p loss. The KLF6 (Kruppel-like transcription factor) tumor suppressor gene on 10p15 is inactivated by loss of heterozygosity (LOH) and/or somatic mutation in a number of human cancers and forced expression of KLF6 in GBM lines inhibits their growth and transformation. In addition, increased expression of its alternatively spliced, cytoplasmic isoform KLF6-SV1 has now been shown to play a role in cancer pathogenesis.