A correlative manometric and endoscopic study of tubal function in chronic otitis media with effusion.

Since return of normal ventilation of the middle ear is a prerequisite for maintenance of an effusion-free ear state after tube fallout, it was our policy to study the tubal function in patients with chronic otitis media with effusion that had been treated with ventilation tubes (VT), and to correlate the manometric with the endoscopic findings. Normal manometric and endoscopic results indicated good tubal function, with an effusion recurrence rate of 11.1%. Abnormal manometric and endoscopic results indicated organic tubal obstruction that was, in most cases, correctable. Nasal endoscopy proved to be indispensable in diagnosing, localizing and even treating "hidden" lesions in their key areas that may be responsible for the obstruction. Thus, correction of the organic tubal obstruction must precede VT removal if recurrence of effusion is to be prevented. Whenever tubal obstruction is diagnosed as functional or idiopathic, ventilation of the middle ear should be maintained by frequent intubation or the insertion of long-term VT, and a guarded prognosis given.