Contents
- Catheterization of the auditory tube
- Preparation for catheterization of the auditory tube
- How is catheterization of the auditory tube performed?
- Results of catheterization of the auditory tube
- Indications for catheterization of the auditory tube
- Contraindications for catheterization of the auditory tube
- Complications during catheterization of the auditory tube
- More information about catheterization
Catheterization of the auditory tube
– a therapeutic and diagnostic procedure in which a catheter is inserted into the auditory (Eustachian) tube connecting the middle ear cavity with the oropharynx. An ear catheter (Hartmann cannula) is a specially curved metal tube with a funnel-shaped expansion.
Preparation for catheterization of the auditory tube
Immediately before blowing out the ears, the nasal cavity is prepared – it is cleared of mucus and irrigated with vasoconstrictor drugs to reduce swelling.
How is catheterization of the auditory tube performed?
Under the control of anterior rhinoscopy, a metal catheter is inserted into the nasal cavity along the lower nasal passage. The curved “beak” is directed downwards. The injection is carried out to the posterior wall of the oropharynx. After this, the catheter is turned with its beak towards the middle and pulled towards itself until the moment when it rests on the vomer (median nasal septum). Next, the beak is rotated 120-150 degrees to the lateral side. When it gets into the mouth of the auditory tube, a feeling of failure occurs.
The position of the catheter is controlled by carefully blowing air into the catheter – the patient feels a noise in the ear.
Results of catheterization of the auditory tube
In the event that it was not possible to catheterize the auditory tube, the V degree of tube patency is set.
To assess the patency of the Eustachian tube after catheterization, a test with saccharin or dye (methylene blue) is used. These tests can only be performed if there is a perforation in the eardrum. During these tests, an appropriate solution is injected into the tympanic cavity. Normally, after 8-10 minutes, the injected substance appears in the nasopharynx, which is felt by the patient as the appearance of a sweet taste (when tested with saccharin) or the appearance of bluing in the oropharynx is noted (when tested with dye). A satisfactory test is considered to be the appearance of these signs after 10-25 minutes, an unsatisfactory test – after more than 25 minutes.
Indications for catheterization of the auditory tube
- Catheterization is performed to assess the ventilation and drainage functions of the auditory tube. During catheterization, as well as other tests (Valsalva, Toynbee), when blowing the ears according to Politzer, the ventilation capacity of the Eustachian tube is assessed.
- Catheterization is also indicated in the treatment of the consequences of tubo-otitis. Medicines can be administered through the catheter.
- Catheterization is performed when policerization is unsuccessful, or the anatomical features of the soft palate make it impossible to perform blowing.
Contraindications for catheterization of the auditory tube
- Acute inflammatory diseases of the nose, nasopharynx and oropharynx, due to the high probability of infection in the middle ear cavity, which can lead to purulent otitis media.
- Neurological and mental diseases in which intense impact on the hearing organ can provoke loss of consciousness or convulsions. Such diseases include epilepsy and Parkinson’s disease.
Complications during catheterization of the auditory tube
- bleeding;
- trauma to the mucous membrane of the nasopharynx;
- emphysema of the peripharyngeal tissue.
The success of catheterization depends on several factors. First of all, this is the experience of the doctor performing the procedure. The result is least affected by anomalies of the nasal septum – its curvature, the appearance of scars on it. The procedure is complicated by narrow nasal passages and nasal polyposis.
More information about catheterization
The disadvantages of catheterization include the invasiveness of the method. This procedure is quite unpleasant and in sensitive people it can lead to fainting. Recently, catheterization is used quite rarely, mainly in hospitals. To diagnose diseases of the hearing organ, objective research methods come to the fore: otoscopy using a video otoscope, endoscopy of the internal opening of the auditory tube.
Catheterization is complemented by dynamic tympanometry, which makes it possible to quantify the pressure in the tympanic cavity and calculate its gradient during various tests.
At the Prima Medica medical center you can undergo examination by experienced otolaryngologists by appointment by calling +7 495 120-01-07. Prices for services can be viewed here.