EAR INFLATION

From Big Medical Encyclopedia

EAR INFLATION — the procedure of introduction of a pressured air to a drum cavity through an Eustachian tube with the diagnostic and medical purpose.

The item at. use for definition of passability of an Eustachian tube (see. Acoustical pipe ), it is frequent in combination with an ear manometriya (see. Manometriya ear ); apply at treatment of serious consequences and hron. inflammations of a middle ear (see. Otitis , Tubo-otitis ), later tympanoplasties (see). Ear inflation is contraindicated at acute inflammatory processes in a nose and a nasopharynx (a nasal part of a throat, T.) because of a possibility of a drift an air stream of an infection in a drum cavity and development of acute purulent average otitis.

The simplest methods are ear inflations by means of usual swallowing, swallowing at the clamped nostrils (Toynbee's experience) and a sharp exhalation at the clamped nostrils and with the closed mouth (see. Valsalva experience ). These methods often use for improvement or recovery of passability of an Eustachian tube at differences of barometric pressure at take off and landing of the airplane, underwater descents, etc. (see. Barotrauma , Barofunction ).


In a wedge. to practice use also ear inflation on Polittsera and by catheterization of an Eustachian tube.

Fig. 1. Ear inflation on Polittsera by means of the rubber bulb connected by a rubber tube to the olive entered into a nose of the patient.

The item at. on Polittsera make by means of the rubber bulb connected by a rubber tube to an olive (fig. 1). The doctor enters an olive into one nostril of the patient and fingers of the left hand presses one wing of a nose to an olive, another — to a partition of a nose to exclude penetration of the blown air through nostrils. In order that the air stream got into a drum cavity, to the patient suggest to make the deglutitory movement or is loud on syllables to pronounce the words «steamship», «cuckoo». At the time of a drink of a pla of pronouncing a shock syllable the palatine velum rises and densely nestles on a back wall of a throat. At this time the doctor the right hand slightly and not forcedly squeezes a cylinder. At most of patients even at easy pressing on a cylinder air passes in a drum cavity. Hit of air in a middle ear is controlled by means of an otoscope — a rubber tube with olives on the ends. One olive of an otoscope is entered into outside acoustical pass of the patient, another — into an ear of the doctor. At the time of the procedure both feel the characteristic blowing noise. At successfully carried out procedure at some patients hearing improves. The item at. with success sometimes it is possible to apply even at small children.

Fig. 2. Ear inflation by means of a rubber bulb and an ear catheter, at the left below — the diagrammatic representation of a lateral wall of a nasal cavity with the catheter entered into a pharyngeal opening of an Eustachian tube. Acoustical passes of the patient and doctor are connected by an otoscope (rubber tube) by means of which the doctor listens to characteristic noise of the passing air.

If ear inflation on Polittsera is ineffective or it is not possible in connection with insufficiency of function of a soft palate, make catheterization of an Eustachian tube, edges consists in inflation of air in a drum cavity by means of an ear catheter (this procedure is not applied at small children). At catheterization force of inflation is more precisely regulated. Besides, this method allows to enter into a drum cavity liquid medicinal substances (a hydrocortisone, etc.). Before catheterization it is necessary to make front and back rinoskopiya (see) for the purpose of identification of possible anatomic obstacles (a hypertrophy of nasal sinks, a curvature of a partition of a nose, an atresia of a postnaris, adenoides, tumors and hems in a nasopharynx, etc.). Apply special curved metal ear catheters (No. 2, 3, 4) to catheterization, on their one end there is a thickening — «beak» which is entered into a pharyngeal opening of an Eustachian tube, and a funneled bell on other end for introduction of a tip of a cylinder (see. Catheters , Otorhinolaryngological tools ). On a bell there is a ringlet specifying the direction of a beak. The size of a catheter is chosen in each separate case depending on the size of the nasal course and a nasopharynx. After greasing of a mucous membrane of a nose of 1 — 2% solution of Dicainum or 5% solution of cocaine enter an ear catheter through a nasal cavity into a pharyngeal opening of an Eustachian tube. The greatest distribution was gained by the next way of its introduction. The catheter withheld big and index by fingers of the right hand is entered into a nostril a beak down and advanced on a bottom of a nasal cavity to a back wall of a throat. Then the catheter is turned on 90 ° a beak to a partition of a nose and extended back until the beak is hooked for the rear edge of a share. Further, turning a beak of a catheter on 180 ° towards a sidewall of a nasopharynx, establish it horizontally, and having turned a beak up for 30 — 40 °, get to a pharyngeal opening of an Eustachian tube. At the same time the ringlet on a bell of a catheter is directed to an outside corner of an eye of the patient on the party of defeat. After that insert a tip of a rubber bulb into a bell of a catheter and make 3 — 5 inflations of air in a drum cavity (fig. 2). About success of the procedure judge by characteristic noise which is listened through an otoscope. At normal passability of an Eustachian tube the soft blowing noise is listened, during the narrowing of a gleam of a pipe — noise weak, discontinuous. In the presence of exudate in a drum cavity characteristic sounds of the bursting air traps are listened.

At certain patients permanent recovery of hearing can occur after 1 — 3 sessions. At short-term improvement of hearing carry out repeated procedures P. at. in 1 — 2 day during 2 — 3 weeks of P. at. it is possible to combine with pneumomassage (see).

At P. at. on Polittsera and by catheterization of an Eustachian tube the following complications are possible: dizziness, sonitus, rupture of a tympanic membrane; at catheterization — bleeding in connection with an injury of a mucous membrane at rough introduction of a catheter and emphysema as a result of forcing of air in friable cellulose of a throat.

Bibliography: The multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 2, page 220, etc., M., 1960.

V. P. Gamov.

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