To the Editor.—Recent reports from this laboratory have dealt with rupture of the tympanic membrane and death or serious complications in guinea pigs resulting from excessive air pressure within the middle ear space.1,2 In this animal it was not possible to demonstrate ventilation of the middle ear space by the eustachian tube. Recent work with the rhesus monkey has revealed that this is species dependent. All primate ears tested showed eustachian tube opening immediately upon rupture of the tympanic membrane. In one ear with serous otitis, there was eustachian tube dysfunction with step-wise reduction in pressure rather than immediate reduction. No death from overpressure resulted. We feel middle ear insufflation via eustachian tube catheterization is probably safer than via the external auditory canal. The basis for this is that in eustachian tube catheterization the tympanic membrane may act as a safety valve and rupture before pressure reached a
GOLDSTEIN CAJ, FISCHER JC. MIDDLE EAR INSUFFLATION. Arch Otolaryngol. 1971;93(5):540. doi:10.1001/archotol.1971.00770060786022
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