Politzerization

Abstract: The combined effect of changes in middle ear (ME) gas composition and changes in systemic arterial blood oxygenation on total ME pressure was studied in three anesthetized juvenile Rhesus monkeys (Macaca mulatta) The gas composition of the ME was altered by ME inflation (politzerization) using either pure nitrogen, oxygen, or carbon dioxide while the animal was ventilated with either room air or 100% oxygen at constant carbon dioxide blood gas tension Total ME pressure was measured indirectly by tympanometry (acoustic impedance) for a 5-hour duration The changes in ME pressure were consistent and reproducible, exhibiting different pressure-time patterns unique for each gas Carbon dioxide resulted in the most rapid decrease in ME pressure, followed by oxygen The slowest decrease was observed in experiments with nitrogen The systemic hyperoxygenation had little or no effect on the results The findings were explained by the differences in relative permeabilities of these gases influencing ME gas diffusion, but the lack of systemic hyperoxygenation effect remained unexplained

Abstract: In the last 15 years, a pressure chamber able to generate negative air pressure has been used to treat patients with Meniere's disease. In this study we sought to clarify whether the underpressure chamber can be used to diagnose Meniere's disease. We studied 45 ears from patients with neurotological diseases. The subjects were placed supine in a soundproof pressure chamber. The pressure was first decreased to -500 mmH2O, and after 5 min to -700 mmH2O. The pressure was kept at this level for another 5 min and then increased to 0 mmH2O. This procedure was done three times in succession. While the chamber pressure was below 0 mmH2O, the subjects were instructed to abstain from actively equilibrating middle ear pressure. When the chamber pressure was raised to 0 mmH2O, they were instructed to equilibrate middle ear pressure, and if necessary Politzerization or catheterization of the Eustachian tube was done. As a result, hearing was improved after this procedure only in patients with Meniere's disease (50%) a...

Abstract: The present study was performed to estimate changes of middle ear pressure (ME-P) during actions of daily life such as nose blowing and sniffing. ME-P was measured in 18 patients with perforation of the eardrum. They were asked to perform actions which included nose blowing and sniffing. Eustachian catheterization and politzerization were also applied. Change of ME-P before and after these actions was recorded using a pressure monitor. Results showed that changes of ME-P after nose blowing with both nostrils closed were large and rapid. The mean value of ME-P after nose blowing was 252 mmH 2 O. In our previous study, the mean value of cerebrospinal fluid pressure (CSF-P) after nose blowing was 388 mmH 2 O. 1 Therefore, the pressure gradient across the cochlear windows is about 130 mmH 2 O during nose blowing. The cochlear windows may have been pressed toward the middle ear side. After sniffing, ME-P was unchanged. These results suggest that nose blowing may be an important cause of perilymphatic fistula (PLF) via the explosive route,2 while sniffing is not likely to cause PLF.

Abstract: Animal experiments have shown that gas absorption can produce a considerable intratympanic underpressure when the gas composition of the middle ear is disturbed. A similar phenomenon was observed in children with serous otitis. In 12 ears with underpressures exceeding — 150 mm H2O, Valsalva inflation or politzerization produced a transient improvement followed by a rapid return to subatmospheric pressures ranging from — 130 to — 300 mm H2O. In four cases with middle ear pressures between — 65 and — 135 mm H2O, the same procedure did not result in any significant underpressures. These findings suggest that inflation of the middle ear in the presence of a deep underpressure serves no purpose. It is also possible that a negative pressure, once established, can be maintained in this way.