2. Index
1. Valsalva Test
2. Politzers Test
3. Catheterization
4. Toynbee's Test
5. Tympanometry
6. Radiological Test
7. Saccarrine or methylene blue test
8. Sonotubometry
3. Valsalva Test
• Principle :-- build positive pressure in the nasopharynx so that air
enters into the eustachian tube
• If air enters into the middle ear tympanic membrane will move
outward
• Hissing sound produced in case of TM perforation
• Cracling sound produced in case of discharge from middle ear
• Performance rate is 65%
• Avoiding in:- atrophic scar of TM,presence of infection in nose and
nasopharynx.
4. Politzers Test
• In children
• Principle:-- olive shape tip of politzers bag introduced into the patient
nostril on the side of which the tubal function is desired to be tested .
• Other nostril is closed and the bag compressed while at the same
time the patient swallows
• Hissing sound is heared if the tube is patent.
• Also used in ventilation of middle ear
5.
6. Catheterization
• Nose anaesthesized by lignocaine
• Catheter is passed along the floor of the nose till it reaches the
nasopharynx
• It is rotated 90° medially and pulled back till the engagement on the
posterior border of nasal septum
• It is then rotated 180° laterally so that the tip lies against the tubal
opening
• Now we connect politzers bag to catheter and air insufflated
• Entery of air is tested by auscultation tube
7. Complications in catheterization
• Scaring of eustachian tube opening by injury
• Bleeding from nose
• Transmission of infection in the middle ear causing ootitis media
• Rupture of atrophic area of TM
8.
9. Toynbees Test
• Based on negative pressure
• Physiological test
• It is performed by asking the patient to swallow while nose has been
pinched,this draws air from the middle ear into the nasopharynx and
causes inward movement of TM
10. Tympanometry
• Negative and positive pressure created in external ear canal and the
patient swallows repeatedly
• Ability to equaliberate negative and positive pressure to the ambient
pressure indicates normal tubal function
• Done in both cases of perforated and intact TM
11. Radiological Test
• Radioopaque dye:- hypaqe,lipoidal instilled into the middle ear
through a pre-existing perforation and X rays taken should delineate
the tube and any obstruction
• Time taken by the dye to reach the nasopharynx also indicates
clearance test function
12. Saccarine or methylene blue test
• saccarine solution is Placed into middle ear
• The time taken by it to reach the pharynx and impart a sweet taste is
also a measure of clearance function test
• Methylene blue dye can be instilled into the middle ear and the time
taken by it to stain the pharyngeal secretions can be noted
13. Sonotubometry
• Tone is presented to nose
• Record from external canal
• Tone louder while tube is patent
• It also tells duration for which the tube remains open
• Non invasive procedures
• Provide information about active tubal opening
