الفهرس 
ANATOMY OF EUSTACHIAN TUBE (ET)Only 14 pages are availabe for public view
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Abstract
Middle ear disorders frequently occur in sinusitis due to the inbetween anatomical and functional connections, through the Eustachian tube. The ET has physiologic functions as aeration of the middle ear to make the middle ear and ambient pressures to be equal, clearance of that secretions produced in the middle ear space into the nasopharynx and protection from reflux of secretions and sound pressures of the nasopharynx into the middle ear space. Eustachian tube plays an important role in pressure regulation of the middle ear (ME). In a clinical context the significance of underpressures in the middle ear are well known being related to both otitis media with effusion and a series of squeals to chronic otitis media. Basically, these underpressures are been explained by a net gas absorption of air from the middle ear cavity including the mastoid which is insufficiently counter-balanced by a decreased air supply due to an impaired Eustachian tube function. The ME has anatomical and functional connections with the nasopharynx through ET and the pathophysiology of its disorders is considered similar to that of sinusitis. chronic inflammation of nasal & sinuses mucosa extends to nasopharyngel mucosa which leads to obstruction of ET opening then ET dysfunction which results in impairment of the middle ear pressure and in fluid exudation with the clinical picture of otitis media with effusion. In this study Eustachian tube dysfunction is evaluated, assessed by tympanometry, in patients with chronic sinusitis and effect of treatment of chronic sinusitis by FESS on ET function, assessed also by tympanometry. Summary & Conclusions - 64 - This study was conducted on 100 patients complaining chronic sinusitis with or without nasal polypi with intact tympanic membrane not responding proper and adequate medical treatment. Those patients had undergone examination thoroughly by clinical examination, endoscopic nasal examination and CT scanning. Tympanometry was done to both ears of all patients before FESS to detect the effect of chronic sinusitis on ET function and ME pressure then done at 1, 3, 6, 9, 12 months after operation to evaluate the improvement of ET function. Tympanometry had proved to be easy, rapid and effective procedure in detecting ET dysfunction and secretory otitis media, and giving good evidence for the effect of chronic sinusitis on ET function and middle ear pressure. It showed that 100 patients (200 ears) had 60 ears with tympanometric changes as 12 ears had type B tympanometry revealing secretory otitis media and 48 ears had type C tympanometry revealing ET dyfunction. By following up patients, it was found that endoscopic functional sinus surgery (FESS) had improved ET function and middle ear pressure as it shown by tympanometry after 12 months 8 ears only show type C tympanometry and with no ears show type B tympanometry. But the role of FESS on ET function and middle ear pressure needs more investigation and studies.