This method is to examine whether or not the auditory tube is unobstructed by squeezing air into the tympanic cavity through the auditory tube; also, ventilation through the auditory tube is applied to check whether there is a small perforation or not. The method regulates the air pressure of the tympanic cavity, helps to eliminate myringeal hydrops and prevents the adhesion of the auditory ossicles. The method of making the auditory tube ventilated is called “ inflation of the auditory tube”. This method can not only check whether the auditory tube is unobstructed or not, but also cure the obstruction of the auditory tube. Its principle lies in the fact that the obstructed auditory tube is burst open by gathering air in the nasopharyngeal region with various methods, or by raising the air pressure. There are three such commonly-used methods.
This method is simple, easy to use and basically free from the organic injury. As early as in the Ming dynasty, Baosheng Miyao (Secrets of Health Preservation) put forth this method: “ Sit down to regulate respiration with teeth clenched firmly. Then hold the nostrils tightly with thumb and index finger and with eyes opening to make qi pass through the ear until there appears the booming sound in the ear. Do the exercise two to three days until the ear is unobstructed.” Actually, the method is the method of blowing the nose. However, the nostrils should be tightly held between two fingers. Do not loosen your grip. Otherwise, nasal discharge will come out. Retaining the grip can maintain the high air pressure in the nasopharyngeal region. The high air pressure bursts the auditory tube open, producing the sensation of air flow entering the cavity of the middle ear as well as sensation of fullness Better effect may be achieved by dripping some 1% ephedrine before the Eustachian tube inflation is conducted.
2. Inflation with a rubber balloon
This is a more commonly-seen mechanical inflation. Ask the patient to keep a mouthful of water in the mouth. Then the operator plugs the olive end of the front part of the rubber balloon in need of the inflation into one lateral anterior nostril of the patient while the other lateral anterior nostril is firmly pressed by fingers. At this time, ask the patient to swallow the water. When the patient is swallowing the water, the operator should grip the rubber balloon tightly. When swallowing the water, the patient should keep the soft palate close to the retropharyngeal wall, close the passage between the nasal cavity and throat. At this moment, the auditory tube should be opened so that the air entering the nasal cavity and accumulated in the nasopharyngeal region from the rubber balloon with greater pressure can be squeezed into the auditory tube and the tympanic cavity.
3. Inflation with a metal catheter
Plug a metal catheter into the patient’s nasal cavity slowly. The operator should aim the catheter at the pharyngeal opening of the auditory tube with the help of his feel. Afterwards, use a rubber balloon to blow air by aiming it at the catheter. This method produces even greater air pressure. Therefore, it is easy to blow the obstruction of the auditory tube open. But it easily breaks the patient’s drum membrane.
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