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Masja Straetemans, PhD; Niels van Heerbeek, MD, PhD; Anne G. M. Schilder, MD, PhD; Ton Feuth, MSc; Ger T. Rijkers, PhD; Gerhard A. Zielhuis, PhD

Arch Otolaryngol Head Neck Surg. 2005;131:118-123.

Objective  To study the role of eustachian tube function in the development of recurrent otitis media with effusion (OME) in children treated with tympanostomy tubes for OME.

Design  Prospective cohort study.

Setting  Three academic and general hospitals.

Patients  Children aged 2 to 7 years with a first clinical episode of OME that persisted for at least 3 months; 136 (81%) of 168 eligible children participated. All children received tympanostomy tubes for bilateral OME at study entry.

Main Outcome Measure  Recurrence of OME within 6 months of tube extrusion.

Results  No statistically significant differences were present in eustachian tube function test results between ears that developed recurrent OME and those that did not. The difference in passive ventilatory function between ears with and without OME recurrence was 10 daPa (95% confidence interval, –24 to 43 daPa) for opening pressure and –3 daPa (95% confidence interval, –18 to 11 daPa) for closing pressure. The overall difference in the proportion of ears with and without OME recurrence that could not equilibrate positive and negative applied pressures was 12% (95% confidence interval, –2% to 26%). The proportions of ears with and without OME recurrence that induced negative pressure in the middle ear by forcefully sniffing were 22% and 31%, respectively (P = .75).

Conclusion  Measurement of ventilatory and protective eustachian tube function using the forced response test, the pressure equilibration test, and the sniff test has no value in predicting whether children have an increased risk of OME recurrence.

Author Affiliations: Departments of Epidemiology and Biostatistics (Drs Straetemans and Zielhuis and Mr Feuth) and Otorhinolaryngology (Dr van Heerbeek), University Medical Centre Nijmegen, Nijmegen, the Netherlands; and Departments of Otorhinolaryngology (Dr Schilder) and Pediatric Immunology (Dr Rijkers), University Medical Centre Utrecht and Wilhelmina Children’s Hospital Utrecht, Utrecht, the Netherlands.

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