Positive Intratympanic Pressure in the Morning and Its Etiology

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Abstract
Intratympanic pressures were measured by tympanometer in forty ears free from disease. In the recumbent position, the first tympanogram was obtained in the morning at awakening, before swallowing. The second pressure measurement was performed in the upright position after swallowing and chewing. Twenty-two ears showed positive pressure in the middle ear before swallowing and decreased pressure after swallowing. The present results revealed no evidence of continuous gas absorption from the middle ear during sleep. The other experiment demonstrated that raising of the PCO2 level by hypoventilation increased the pressure in the middle ear. The results suggested indirectly a diffusion of carbon dioxide to the middle ear cavity from its surrounding tissue. The intratympanic pressure seems limited in part to the partial pressure gradient of gases between the middle ear cavity and its surrounding tissue when ventilation through the Eustachian tube is impaired.

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