Otologic Changes in Tracheostomized, Mechanically Ventilated Patients

Abstract

Background: One of the most often used procedures in intensive care units for patients on mechanical ventilation is tracheostomy. In  order to provide a safe and secure airway for individuals with traumatic brain damage, it is done. Patients with tracheostomies exhibit  both transient and permanent alterations. Numerous investigations indicated that tracheostomies had an increased incidence of middle  ear illness. Tympanostomy is necessary for about 20% of children who have had tracheostomies.

Objective: To evaluate the otologic  changes based on clinical, audiological, and radiological findings in tracheostomized, mechanically ventilated patients.

Patients and  Methods: This retrospective study of 43 tracheostomized, mechanically ventilated selected from intensive and long-term care units from  January 2020 to January 2023. Fifty individuals with unilateral sensorineural hearing loss or tinnitus, with no previous history of ear  surgery or other complaints were selected as a control group.

Results: The study included a total of 86 ears and 100 ears as controls. The  studied groups were comparable regarding age, gender, and laterality. Patients' ears showed significantly higher middle ear effusion  (62.8% vs. 0%, P < 0.001) and tympanic membrane retraction (14% vs. 0%, P < 0.001). Tympanometry results significantly differed between  the studied groups (P < 0.001). Type B was the most frequent type in the patients' group (62.8%), followed by types A (22.1%), C (11.6%),  Ad (2.3%), and As (1.2%). Radiologically, patients' ears showed significantly higher eustachian tube obliteration (68.6% vs. 0%, P < 0.001),  middle ear cavity effusion (62.8% vs. 0%, P < 0.001), mastoid air cells effusion (55.8% vs. 0%, p < 0.001), and petrous apex effusion (5.8% vs.  0%, P = 0.02).

Conclusion: Prolonged tracheostomized and mechanically ventilated patients exhibit a significant incidence of middle   ear changes as determined by clinical, audiological, and radiological assessments.