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Tympanic injury secondary to positive pressure mask ventillation is rare. During resuscitative procedures, two patients developed partial deafness, one from disarticulation of the incudomalleal joint, the other from an oval window perilymph fistula. Excessive pressure transmitted rapidly through the eustachian tube is postulated to have caused both injuries.

Contrast roentgenography and cineroentgenography were carried out on nine patients with perforated eardrums to reveal the opening process of the Eustachian tube and its pumping-like clearance function in human beings. The results were as follows: (1) the tubal lumen opens along the cartilaginous part of the tube owing to the outward displacement of its lateral wall; (2) the pumping function of the tube consists in two phases: accumulation of the fluid in the tube by tensor contraction and discharge of the fluid by tensor relaxation.

An analysis of 227 consecutive tympanomastoldectomies was undertaken to compare the types and degree of middle ear pathologic features that are found behind central perforations as compared with attic or marginal perforations. In this series, little difference was found between the two groups. A great deal of disease occurred behind all types of tympanic membrane perforations. Near-normal audiogram results did not guarantee a normal middle ear. Central perforations are not necessarily safe and should be treated with the same caution as attic or marginal perforations.

The widely accepted treatment of chronic serous otitis media with ventilation tubes has resulted in an apparently acceptable level of complications. Perhaps because of the extreme variability in the type of tube used and the methods of inserting these tubes, little attention has been paid to the incidence of these complications. To arrive at preliminary complication rates that may be used in discussion with parents, 307 patients who were under 10 years of age and treated with tympanostomy tubes were evaluated retrospectively to document the rate of complications. The literature was screened for other series of patients treated with tympanostomy tubes where data regarding complications were available, and comparisons were made to determine the value of these figures. The level of simple complications was high, but the incidence of serious complications was low enough to support the further use of this method of therapy.

Mucociliary function of the eustachian tube was measured with a radioisotopic method; 0.01 mL of a human serum albumin labeled with technetium 99m was instilled into the anterior part of the middle ear cavity either through a perforation or by puncturing the tympanic membrane, and its course was followed by a gamma-camera. In the normal eustachian tube, the velocity of the mucociliary transport was 0.7 to 1.1 mm/min. The mucociliary function was totally absent in chronic otitis media, in untreated secretory otitis media, and in the ear with a moist perforation of the tympanic membrane. The mucociliary transport returned to normal when the ear was clinically healed. It is assumed that the impairment of the mucociliary function of the eustachian tube and middle ear plays an important role in the pathogenesis of secretory otitis media and chronic ear discharge.