Topical application of decongestant in dysfunction of the Eustachian tube: a randomized,double-blind,placebo-controlled trial

Thirty-six patients, aged 12–75 years, with dry, central tympanic membrane perforations and a negative Valsalva manouevre and/or a negative aspiration/ deflation test, were included in a randomized, double-blind, placebo-controlled trial on the effect of a decongestant agent (xylometazoline chloride 0.1%) and placebo (saline 0.9%) applied directly to the pharyngeal opening of the Eustachian tube. Judged by the Valsalva manouevre, tubal patency was significantly improved after application of the active drug (P<0.003). In contrast, no effect was demonstrated by the aspiration test (P=0.80) or the deflation test (P=0.51). It is concluded that a topical decongestant improves Eustachian tube function but only at unphysiologically high pressures.