The Effect of Postoperative Eustachian Milking Maneuver on Eustachian Tube Dysfunction

Eustachian Dysfunction Occurring After Adenoidectomy and/or Adenotonsillectomy and the Effect of Postoperative Eustachian Milking Maneuver on Eustachian Dysfunction

This study will evaluate the effectiveness of this lymphatic drainage method in eliminating otalgia interruption due to eustachian dysfunction and reducing middle ear pressure, which occurs in the postoperative period after adenoidectomy and/or adenotonsillectomy.

Study Overview

• Status: Completed
• Conditions: Postoperative Middle Ear Pressure; Otalgia
• Intervention / Treatment: Other: Eustachian milking maneuver with routine postoperative treatment protocol; Other: Routine postoperative treatment protocol

Detailed Description

The eustachian tube lies between the middle ear and the nasopharyngeal cavity and provides ventilation of the middle ear. The most important function of the Eustachian tube is to balance the air pressure in the middle ear with atmospheric pressure.

Temporary eustachian dysfunction and ear fullness occur in the early postoperative period after adenoidectomy and/or adenotonsillectomy. This temporary eustachian dysfunction is considered to be caused by clots and edema in the nasopharynx after surgery. In addition, trauma to the eustachian tube during adenoidectomy performed by curettage also contributes.

Eustachian dysfunction may present at the post-operative period resulted in otalgia related to middle ear pressure in the pediatric patients undergoing adenoidectomy or adenotonsillectomy. In this case, the need for analgesic agents rises in the early postoperative operiod and beyond this stituation impairs the quality of the healing process.

Reducing middle ear pressure by ensuring the mobility of the eustachian tube with the eustachian milking maneuver, which is a lymphatic drainage method, may reduce the otalgia symptoms during the post-operative recovery period, thus reducing the use of analgesic agents and improving the quality of the healing process. The aim of this observational study is to investigate to what extent a eustachian therapy maneuver corrects the negative values in middle ear pressure in the postoperative period.

• Study Type: Observational
• Enrollment (Actual): 80

Contacts and Locations

Study Locations

• Turkey
  • Karaman, Turkey
    • Karaman Training and Research Hospital, Karaman

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

80 patients aged 3-15 years who were indicated for adenoidectomy and/or adenotonsillectomy.

Description

Inclusion Criteria:

Patients with ASA 1 and 2 The parent will be able to perform eustachian milking manoeuvres

Exclusion Criteria:

Tympanometric examination performed in the preoperative period revealed eustachian dysfunction Craniofacial malformation

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Grup 1; The children undergoing adenoidectomy and/or adenotonsillectomy whose parents will apply eustachian milking maneuver in the post-operative period.	Other: Eustachian milking maneuver with routine postoperative treatment protocol; Eustachian milking maneuver will be applied by the patients parents 3 times a day for 7 days in the post-operative period.; Other: Routine postoperative treatment protocol; The children adenoidectomy and/or adenotonsillectomy whose parents will not apply eustachian healing maneuvers in the post-operative period.
Grup 2; The children undergoing adenoidectomy and/or adenotonsillectomy whose parents will not apply eustachian milking maneuvers in the post-operative period.	Other: Routine postoperative treatment protocol; The children adenoidectomy and/or adenotonsillectomy whose parents will not apply eustachian healing maneuvers in the post-operative period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Middle ear pressure	Tympanometry is an objective test of middle-ear function. The test is performed by inserting the tympanometer probe in the ear canal. The instrument changes the pressure in the ear, generates a pure tone, and measures the eardrum responses to the sound at different pressures. This produces a series of data measuring how admittance varies with pressure, which is plotted as a tympanogram	Perioperative period

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluation of postoperative otalgia symptoms	Postoperative pain related to ear will be evaluated with Visual Analog Scale (VAS). Children will be asked to choose the pain they feel according to the facial expression in the picture. 0 indicates no pain, 10 indicates severe pain.	Postoperative period

Collaborators and Investigators

• Sponsor: Karaman Training and Research Hospital
• Investigators: Principal Investigator: Ayşe Duran, MD, Karaman Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): October 22, 2024
• Primary Completion (Actual): December 30, 2024
• Study Completion (Actual): January 30, 2025

Study Registration Dates

• First Submitted: September 18, 2024
• First Submitted That Met QC Criteria: September 18, 2024
• First Posted (Actual): September 20, 2024

Study Record Updates

• Last Update Posted (Actual): April 17, 2025
• Last Update Submitted That Met QC Criteria: April 16, 2025
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Keywords: Analgesia; Eustachian dysfunction; Eustachian Milking Maneuver
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Otorhinolaryngologic Diseases; Ear Diseases; Earache
• Other Study ID Numbers: 04-2024/03