KAREN H.CALHOUNMDRONALD B.KUPPERSMITHMDFrom the Department of Otolaryngology– Head and Neck Surgery, University of Massachusetts Medical School, University of Massachussets Memorial Medical Center, Worcester, Mass.
Dr Megerian has provided us with a substantial review of the literature regarding methods of preoperative evaluation of eustachian tube function in children, and how the results of these evaluations relate to the success rate of tympanoplasty. He is correct in stating that it is almost impossible after review of the literature to clearly support or refute the hypothesis that pediatric tympanic membrane perforations can be successfully repaired if the child can taste otologic drops instilled in the ear canal. The idea of evaluation using instilled drops is interesting, but the results are based on a subjective response from patients. One factor that should be considered is that while this may be helpful in the older child, stimulus of the vagus and/or glossopharyngeal nerves may confuse a young child and evoke an erroneous response.
Westerman ST. Tasting Instilled Otologic Drops Is Not a Reliable Test of Eustachian Tube Function. Arch Otolaryngol Head Neck Surg. 2000;126(8):1042. doi:10.1001/archotol.126.8.1042
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