Accuracy of the ETDQ‐7 for Identifying Persons with Eustachian Tube Dysfunction

Teixeira, Miriam S.; Swarts, J. Douglas; Alper, Cüneyt M.

doi:10.1177/0194599817731729

Cited by 60 publications

(67 citation statements)

References 26 publications

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“…Receiver operating characteristic (ROC) curve analysis of the ETDQ‐7 identified a cut point total score of ≥14.5 (mean score = ≥2.1) with perfect 100% sensitivity and 100% specificity for diagnosing a patient with ETD . Teixeira et al compared the ETDQ‐7 to objective eustachian tube function tests (the pressure chamber test and the inflation‐deflation test) on a population of control patients and a population of ETD patients, and found that an ETDQ‐7 score >14.5 had higher sensitivity and specificity than the objective tests . However, the ETD population of that study included not only patients with objective signs of ETD (recurrent otitis media, middle ear effusion, need for tympanostomy tubes) but also patients who only had symptoms of aural fullness and pressure, so its findings may be flawed.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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Objectives/Hypothesis Ear fullness and pressure is a common complaint seen in otolaryngology clinics and frequently is attributed to eustachian tube dysfunction (ETD). In addition to traditional tympanometry and physical examination, the seven‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) has recently been used to aid in the diagnosis of ETD and to assess its severity. Temporomandibular joint disorder (TMJD) is a common condition that causes similar symptoms to ETD and has been recognized as a potential confounding condition in patients presenting with ETD symptoms. We sought to determine the cross‐sectional prevalence of ETD symptoms in patients with TMJD using the ETDQ‐7. Study Design Prospective cross‐sectional analysis. Methods An analysis was performed of ETDQ‐7 scores in patients diagnosed with TMJD. Results A total of 21 patients with confirmed TMJD completed the ETDQ‐7 at routine consult or follow‐up for their TMJD. The mean ± standard deviation ETDQ‐7 score for the cohort was 24.5 ± 12.5. Two‐thirds of patients had an ETDQ‐7 score of >14.5, which has been used in the literature to denote clinically significant ETD. No single question was scored significantly higher than the others. Conclusions Symptoms of ETD are highly prevalent among patients with TMJD determined by patient‐reported outcome measures. It is not clear if these symptoms reflect true derangement of eustachian tube function in these patients or whether there is only clinical similarity between ETD and TMJD. However, future research efforts may resolve this dilemma. Level of Evidence 4 Laryngoscope, 130:E233–E236, 2020

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Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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“…Although largely unmeasured, the assumption has been that the clinical diagnosis reliably translates to the ability of the ET to perform its physiological functions; opening to permit ME pressure equalisation and drainage, and protection of the middle ear. In recent years this link has been questioned, with reports that symptoms and the results of objective tests (tympanometry[ 24 ], tubomanometry[ 25 , 26 ] and middle ear pressure equilibration tests[ 27 ]) were not closely matched. In this study PCA and correlation matrices demonstrated that patient symptoms measured by PROMs, and ET function measured by tests of ET opening for OETD and PETD, appear poorly correlated and vary independently.…”

Section: Discussionmentioning

confidence: 99%

Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway

et al. 2018

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Background and aimsEustachian tube dysfunction (ETD) is a commonly diagnosed disorder of Eustachian tube opening and closure, which may be associated with severe symptoms and middle ear disease. Currently the diagnosis of obstructive and patulous forms of ETD is primarily based on non-specific symptoms or examination findings, rather than measurement of the underlying function of the Eustachian tube. This has proved problematic when selecting patients for treatment, and when designing trial inclusion criteria and outcomes. This study aims to determine the correlation and diagnostic value of various tests of ET opening and patient reported outcome measures (PROMs), in order to generate a recommended diagnostic pathway for ETD.MethodsIndex tests included two PROMs and 14 tests of ET opening (nine for obstructive, five for patulous ETD). In the absence of an accepted reference standard two methods were adopted to establish index test accuracy: expert panel diagnosis and latent class analysis. Index test results were assessed with Pearson correlation and principle component analysis, and test accuracy was determined. Logistic regression models assessed the predictive value of grouped test results.ResultsThe expert panel diagnosis and PROMs results correlated with each other, but not with ET function measured by tests of ET opening. All index tests were found to be feasible in clinic, and acceptable to patients. PROMs had very poor specificity, and no diagnostic value. Combining the results of tests of ET function appeared beneficial. The latent class model suggested tympanometry, sonotubometry and tubomanometry have the best diagnostic performance for obstructive ETD, and these are included in a proposed diagnostic pathway.ConclusionsETD should be diagnosed on the basis of clinical assessment and tests of ET opening, as PROMs have no diagnostic value. Currently diagnostic uncertainty exists for some patients who appear to have intermittent ETD clinically, but have negative index test results.

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“…While the occurrence of aural symptoms or otic barotrauma on exposure to significant pressure changes is well recognised, baro-challenge-induced OETD is a relatively new term introduced in the 2015 definition of ETD. Previous work has demonstrated that many symptoms associated with ETD do not correlate with underlying ET function measured by objective tests [Jenckel et al, 2014;Liu et al, 2016;Singh et al, 2017;Smith et al, 2018a, b;Teixeira et al, 2018]. However, of all ETD-related symptoms, aural pain on baro-challenge might have been expected to correlate well with obstructive dysfunction, as the symptom appears to be more specific to the condition, being presumed related to inadequate ME pressure equalisation.…”

Section: Discussionmentioning

confidence: 99%

Eustachian Tube Function in Patients with Symptoms on Baro-Challenge

Smith¹,

Bance²,

Tysome³

2020

Audiol Neurotol

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Objectives: To explore the relationship between aural symptoms during baro-challenge and the underlying measured Eustachian tube (ET) function. Two key questions were addressed. (1) In patients who have features of obstructive ET dysfunction, is there a measurable underlying difference in ET function between those who experience severe symptoms on baro-challenge and those that do not? (2) What is the diagnostic value of ET function tests in the identification of patients with severe symptoms on baro-challenge? Methods: Patients with symptoms of obstructive ET dysfunction were recruited, with the presence of aural symptoms on baro-challenge established via the clinical history and analysis of the Cambridge ET Dysfunction Assessment, a patient-reported outcome measure (PROM). ET function tests were assessed in each patient: 9 objective and semi-objective measures of ET opening, and 2 symptom-based PROMs. The tests' results were grouped by type of ET opening assessed, generating passive and active dysfunction scores. Individual test results were assessed for diagnostic accuracy in reference to features in the history or PROM-based evidence of symptoms on baro-challenge. Results: Both passive and active opening of the ET was significantly reduced in ears with a history of pain on baro-challenge. Some patients had apparent severe obstructive ET dysfunction without symptoms on baro-challenge, whilst others had symptoms but normal test results. No individual test of ET opening was of diagnostic value in predicting those ears likely to experience pain or exacerbated symptoms on baro-challenge. Conclusion: The relationship between aural pain during baro-challenge and ET function appears more complex than had been assumed, with pain possibly related to factors other than just ET function.

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Accuracy of the ETDQ‐7 for Identifying Persons with Eustachian Tube Dysfunction

Cited by 60 publications

References 26 publications

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway

Eustachian Tube Function in Patients with Symptoms on Baro-Challenge

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