Thursday, 22 December 2011

Eustachian Tube Catheter



The Eustachian catheter is a long, thin metal instrument mainly used to test Eustachian tube patency but with a few other uses as well.

It is actually a curved, metal cannula, measuring about 5 inches in length. Its tip is curved gently downwards. The other end bears a small metal ring in the direction of the curve. This ring serves as a guide to the direction of the curve once the tip is inserted into the nose.

Uses:

  • Eustachian tube catheterization
  • Nasal foreign body removal – The Eustachian catheter is sometimes used for removal of foreign bodies from the nose. It is a sturdy instrument whose curved tip can be used to nudge and maneuver foreign bodies lodged in the nasal cavity.

How Eustachian tube catheterization is done

This procedure is more than a century old and was earlier routinely done to check patency of the Eustachian tube.

  • The tip of the catheter is inserted into the nose and passed along the floor of the nasal cavity till it touches the posterior pharyngeal wall. The tip is now in the nasopharynx.
  • It is then rotated 90° medially and drawn forward till it meets resistance. The tip is now touching the posterior free end of the nasal septum.
  • At this point, the tip is rotated 180° laterally so that it enters the opening of the Eustachian tube in the lateral wall.
  • A Politzer bag is attached to the other end of the catheter. Air pushed from it can be heard rushing into the ear if the Eustachian tube is patent.

The medial and lateral rotations that appear to complicate the procedure were actually designed to avoid the tubal elevation located behind the tubal opening since the tip cannot be seen once inserted into the nose. The original procedure was a blind one, with only the metal ring to indicate the direction of the catheter’s tip. But the procedure can also be done under endoscopic guidance.

The important thing to remember is that the method only tests patency of the Eustachian tube and does not reflect on its function.

Other methods to test Eustachian tube patency

  • Seigelization (or pneumatic otoscopy)
  • Valsalva maneuver
  • Politzerisation
  • Toynbee’s test


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