Tuba Östaki Hastalıkları
Özet
Tuba östaki (TÖ), nazofarenks ile orta kulak boşluğunu bağlayan, kemik ve kıkırdaktan oluşan huni şeklinde anatomik bir yapıdır. En dar yeri istmus olan TÖ, dinlenme halinde kapalı olup yutkunma, esneme ve çiğneme gibi eylemlerle açılır. TÖ'nin temel fonksiyonları orta kulak basıncını düzenlemek, orta kulağı nazofarengeal sekresyon ve patojenlerden korumak ve timpanik kavitedeki sekresyonları temizlemektir. Küçük çocuklarda horizontal ve kısa yapısı nedeniyle enfeksiyonlara yatkınlık daha fazladır. TÖ disfonksiyonu, orta kulağın havalanmasının bozulması ve negatif basınç oluşumuyla karakterize olup kulakta dolgunluk, ağrı, tinnitus ve işitme kaybına yol açar. Tedavisinde medikal ajanlar, ventilasyon tüpü ve yeni bir yöntem olan balon östaki tuboplasti kullanılır. İstirahat halindeyken bile tüpün açık kalması durumu olan patuloz tuba östaki ise genellikle hızlı kilo kaybı ve hamilelikle ilişkilendirilir. Ses ve solunum otofonisi, dolgunluk ve tinnitus gibi yaşam kalitesini düşüren semptomlara neden olan bu durumun tanısında timpanik membranın solunumla senkronize hareketi patognomoniktir. Tedavisi konservatif yöntemlerden, lümene hacim artırıcı enjeksiyonlar veya kıkırdak ile tıkama gibi cerrahi müdahalelere kadar değişiklik gösterir.
The eustachian tube (ET) is a cone-shaped anatomical structure composed of bone and cartilage that connects the nasopharynx to the middle ear cavity. The ET, with the isthmus being its narrowest part, is closed at rest and opens during swallowing, yawning, and chewing. Its primary functions include regulating middle ear pressure, protecting the middle ear from nasopharyngeal secretions and pathogens, and clearing secretions from the tympanic cavity. Due to its horizontal and shorter structure in young children, susceptibility to infections is higher. ET dysfunction is characterized by impaired ventilation and negative pressure in the middle ear, leading to symptoms like ear fullness, pain, tinnitus, and hearing loss. Treatment involves medical agents, ventilation tubes, and a novel method called balloon eustachian tuboplasty. Patulous ET, a condition where the tube remains open even at rest, is commonly associated with rapid weight loss and pregnancy. Causing symptoms that significantly reduce quality of life such as vocal and respiratory autophony, fullness, and tinnitus, its diagnosis is pathognomonic with the respiratory-synchronized movement of the tympanic membrane. Treatment ranges from conservative methods to surgical interventions like volume-bulking injections into the orifice or plugging with cartilage.
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