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The influence of the positive airway pressure on the function of the Eustachian tube
Project IdSGS16/LF/2022
Main solverMUDr. Michaela Masárová
Period1/2022 - 12/2022
ProviderSpecifický VŠ výzkum
Statesolved
AnotationObstructive sleep apnea (OSA) is a serious disease associated with a high risk of developing cardiovascular diseases. It is characterized by repeated episodes of complete or partial upper airway (UA) obstruction that leads to respiratory arrest during sleep. The gold standard for the treatment of patients with OSA is positive airway pressure ventilation (PAP). The principle of this therapy is to create a positive pressure in the UA, which acts as a pneumatic plate and prevents the formation of obstruction. PAP treatment can lead to many side effects. One of the discussed negative effects of treatment with overpressure ventilation is the disruption of middle ear pressure conditions. The positive air pressure blown into the UA and nasopharynx can affect the pressure in the middle ear through the Eustachian tube. The Eustachian tube is normally closed and only opens during swallowing, chewing and sneezing to equalize the middle ear and atmospheric pressure. It is the positive pressure in UA that can cause its non-physiological opening with a consequent increase in middle ear pressure. Patients with OSA treated with PAP often suffer from a feeling of fullness of the ears. Dysfunction of the auditory canal can also lead to chronic otitis media and subsequently to serious and life-threatening complications (brain complications). Nevertheless, there are limited data regarding the long-term effects of positive pressure in UA on the middle ear pressure. According to the first results of published studies (not examining more detailed ventilation parameters), it appears that this problem could affect 10-12% of patients. These patients will be offered balloon dilatation of the Eustachian tube. This is a relatively new method of improving the function of the Eustachian tube by dilating its cartilaginous part. We therefore anticipate improved middle ear ventilation, alleviation of complications, and better compliance with PAP therapy in these patients.