Results
A total of 72 ears underwent our testing. These included 21 ears of TP patients and 51 ears of COME patients. There was no statistical difference in age and gender between the two groups (Table 1). Our results showed that 85.7% ears of TP patients had active and passive ET opening function while only 11.8% of COME ears had similar findings; 13.7% ears of COME patients and 4.8% ears of TP subjects had only passive opening function while 27.5% ears of COME patients and 9.5% ears of TP patients only had active opening function; 47.1% ears of COME patients did not demonstrate both active and passive opening function andnone ears of the TP subjects depicted this phenomenon(Table 2). There was a significant difference in both active and passive ventilation function between the two groups(P<0.001). 85.7% ears in the TP group had both active and passive ET function while 88.2% ears in the COME group had ETD.
We found 90.5% (19/21) ears with TP whose ETs could be passively opened. The ranges of Po and Pc were each 215~480 daPa and 25~160 daPa and the mean values were 305.1±41.6daPa and 82.1±37.2 daPa respectively. In the COME ears, only 25.5%(13/51) ETs had passive opening function; the ranges of Po and Pc were 230~491daPa and 30~105daPa, with a mean of 292.5±59.6daPa and 70.5±20.7daPa respectively. However, no significant differences in Po (P=0.49) and Pc (P=0.27) were found in our test (Table 3).
In the TP group, 95.2% (20/21) ears had active ET opening under positive MEP, and 85.7% (18/21) ETs could open actively during the negative phase. The ranges of Pr under positive MEP and negative MEP were 0~50 daPa and -103~0 daPa. In those patients with active ET opening function, we observed that almost every swallow could trigger an ET opening (Fig. 3)with the magnitude of each ET opening (ΔP) ranging from 8 to 85 daPa and the mean ET openings during 10 swallows was 9.1. The waveform after each opening had very good consistent shape and the mean duration of the ET opening was 0.50±0.13s. While recording the MEP-time curve, a rebound wave (Fig. 2, Fig. 3) could be seen at the tail of the waveform in 90% (19/21) ears. In contrast, 39.2%(20/51) ears from the COME group had active ET opening under positiveMEP and only 7.8% (4/51) ears had passive opening under negativeMEP.The ranges of Pr under positive MEP and negative MEP were 35~180 daPa and -192~-98 daPa respectively. The mean Pr under positive MEP was much higher in the COME group (99.7±46.1 daPa) than that in the TP group (16.9±16.8 daPa) (P<0.001). In our tests, we observed that the features of the swallowing waves in COME group performed differently with the TP group (Fig. 4). Some patients under each swallow could trigger an active ET opening but the magnitude of each opening was very small (ΔP<8daPa).Among the patients with ET active opening function, not every swallow resulted in effective opening of the ETor the ET even remained unopened, and we found the average ET openings in 10 swallows was 3.8 in COME groupwhich was much less in comparison to those patients in the TP group (P<0.001); in addition, the rebound wave could only be observed in 20% ears in the COME group which was again significantly less than that in the TP group (P<0.001). The mean duration of the ET opening was 0.63±0.13s, which was slightly longer than that in the TP group (P=0.004) (Table 3).