Correlations between videoendoscopy and sonotubometry of eustachian tube opening during a swallow

Abstract

Objective Describe the relationship between the magnitude of Eustachian tube (ET) dilation during swallowing observed on trans-nasal videoendoscopy and quantified by sonotubometry. Study Design Descriptive observational study Methods Simultaneous trans-nasal videoendoscopic and sonotubometric recordings were done on 33 adults with no middle-ear disease. Briefly, microphones were placed in the ear-canals, a 45° telescope introduced through one side of the nose to visualize and record ipsilateral ET movements, and the probe from a sound generator placed in the opposite nostril. At a generated nasopharyngeal sound-level, ET movements and ipsilateral microphone signals were continuously recorded while the subject performed a series of 3 swallows. For each swallow, relational movements among ET structures observed on video-recordings and characteristics of the sonotubometry signal envelope at the ear-canal were quantified at 3 times, swallow onset (T1), maximum soft-palate elevation (T2), and maximum ET luminal dilation (T3). Results A total of 99 swallows were analyzed. The average medial rotation of the ET cartilage and lateral wall over the T1-T2 interval were −32.7±14.9° and 7.2±25.1°, and over the T2-T3 were 4.6±7.7° and 6.2±14.6°, respectively. The trans-tubal sound transmission during a swallow peaked at an amplitude of 30.5±35.7 mV during the 572.5±292.6 msec of elevated sound-pressure time. Correlational analysis documented significant linear associations between the relational measures of ET component movements from videoendoscopy and the signal envelope measures from sonotubometry. Conclusion There is a direct linear relationship between the degree of ET luminal dilation visualized on videoendoscopy and represented in the sonotubometry signal envelope.

Presentation and eustachian tube function test results in children evaluated at a specialty clinic

“…A thorough medical history was obtained, including the risk factors and otologic history specific to ETD, but no tests were performed in this clinic to diagnose or verify the risk factors. Retraction of the TM was graded using the Sade classification; ETF tests were done as applicable and tolerated, and included the inflation–deflation test, forced response test (FRT), pressure chamber test, and the nasopharyngeal Valsalva, Toynbee, sniff, and dive maneuvers as previously described . Ears with intact TMs underwent testing with the pressure chamber, and nonintact TMs underwent FRT testing.…”

“…Retraction of the TM was graded using the Sade classification 18,19 ; ETF tests were done as applicable and tolerated, and included the inflation-deflation test, forced response test (FRT), pressure chamber test, and the nasopharyngeal Valsalva, Toynbee, sniff, and dive maneuvers as previously described. [20][21][22][23][24][25][26][27][28] Ears with intact TMs underwent testing with the pressure chamber, and nonintact TMs underwent FRT testing. All ears underwent testing for measurement of the percent correction of positive and negative pressure differences (inflationdeflation test for nonintact TMs and pressure chamber test for intact TMs) and nasopharyngeal maneuvers when possible.…”

Advances in Eustachian tube function testing

“…Endoscopy has been described as an assessment tool for ET function, to confirm both ET patency 39 , 40 and opening,41, 42, 43 with correlation shown with other tests of ET opening 44 , 45 . It remains largely subjective and highly dependent on operator experience.…”

Morphological Observations of the Bony Canal Structure of the Eustachian Tube in Elderly Human Cadavers With Cone-Beam Computed Tomography and Principal Component Analysis

“…The magnitude of ET dilation during swallowing, 8 physiological ear clicks with deglutition or during other pharyngeal movements, 9 and the ciliary motion of the mucosa 10 have been reported. The extended length of the supratubal recess is mostly related to the prolonged bony part and the inwardly bending cartilaginous part of the ET in the early stages.…”