Analyzing eustachian tube function in patients with symptoms of chronical Eustachian tube dysfunction by pressure chamber measurements

Meyer, Moritz; Korthäuer, Christine; Jansen, Stefanie; Hüttenbrink, Karl-Bernd; Beutner, Dirk

doi:10.1007/s00405-018-4938-z

Cited by 12 publications

(12 citation statements)

References 27 publications

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“…Another diagnostic tool for evaluation of ETD is the pressure chamber test, which involves ear‐specific continuous tympanometric impedance measurements during compression and decompression in a hyper/hypobaric chamber. By measuring ETOP, objective, quantitative, and reliable parameters across a dynamic setting have been reported for normal, healthy individuals, and patients with both obstructive ETD and specifically BCETD 51–53 . Passive ETOP has been found to be much higher in patients with BCETD (5 ± 2.9 kPa) compared to healthy individuals (3.0 ± 1.5 kPa) 51,52 .…”

Section: Discussionmentioning

confidence: 99%

“…By measuring ETOP, objective, quantitative, and reliable parameters across a dynamic setting have been reported for normal, healthy individuals, and patients with both obstructive ETD and specifically BCETD 51–53 . Passive ETOP has been found to be much higher in patients with BCETD (5 ± 2.9 kPa) compared to healthy individuals (3.0 ± 1.5 kPa) 51,52 . More recently, it has been shown that patients with chronic ETD have improvements in passive ETOP after BDET from 5.1 ± 3.7 to 3.1 ± 1.9 kPa ( p = 0.001) and that the pressure chamber test could be a more reliable assessment tool for postdilation improvement than patient‐reported outcomes 24 .…”

Section: Discussionmentioning

confidence: 99%

“…In order to adequately pool data, outcomes were not stratified by time‐point. While this is justified by the findings that for obstructive ETD, both the short (6 weeks) and long (3 to 12 months)‐term follow‐up results have shown stability, it is unknown if postoperative results remain stable for patients with BCETD 51 . Additionally, the ETDQ‐7 is meant to assess symptoms within the last 30 days; however, if patients had not experienced a baro‐challenge event during that time, ETDQ‐7 scores might not accurately reflect symptom severity.…”

Section: Discussionmentioning

confidence: 99%

“…[51][52][53] Passive ETOP has been found to be much higher in patients with BCETD (5 AE 2.9 kPa) compared to healthy individuals (3.0 AE 1.5 kPa). 51,52 More recently, it has been shown that patients with chronic ETD have improvements in passive ETOP after BDET from 5.1 AE 3.7 to 3.1 AE 1.9 kPa (p = 0.001) and that the pressure chamber test could be a more reliable assessment tool for postdilation improvement than patient-reported outcomes. 24 The subset of patients with BCETD from Jansen et al also showed improvements in passive ETOP from 4.1 AE 1.2 to 3.3 AE 1.2 kPa (p = 0.015), though this is a relatively small cohort of 6 patients with 12 ears.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

et al. 2022

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Objective: To examine the effectiveness of Eustachian tube procedures for the treatment of baro-challenge Eustachian tube dysfunction.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases, including PubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and CINAHL (EBSCO), were searched for articles examining the effectiveness of Eustachian tube procedures for baro-challenge Eustachian tube dysfunction. Outcome measures included symptom resolution, ability to return to work, equalization problems (EP) scores, Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores, and pressure chamber testing parameters. Pooled meta-analysis was performed for dichotomous measures and ETDQ-7 scores.Results: Eleven articles with 81 patients were included. Seventy-two patients from 10 articles underwent balloon Eustachian tube dilation; nine patients in 1 study underwent laser Eustachian tuboplasty (LET). All 81 patients were preoperatively symptomatic with barometric pressure change, and 26/30 (86.7%) were unable to work due to symptoms. On meta-analysis, after balloon dilation Eustachian tuboplasty (BDET), 82.5% (n = 30 [95% confidence interval: 42%-100%]) had improvement in ability to valsalva, 79.1% (n = 16 [57.9%-94.1%]) in ability to return to work, and 84.3% (n = 69 [69.8%-94.7%]) in any symptom. Of 25 patients with individual ETDQ-7 scores, 79.1% [51.4, 96.9] had improvements after BDET. For four case series with 36 patients, ETDQ-7 scores decreased by 1.2 [0.7, 1.7] (p < 0.00001). Of 20 patients with preoperative ETDQ-7 scores >2.0, there was a mean decrease of 2.1 [1.3, 2.8] (p < 0.00001).Conclusion: From the available evidence, Eustachian tube procedures appear to be effective at improving symptoms of baro-challenge Eustachian tube dysfunction. However, higher quality evidence is needed to support making definite recommendations for the use of balloon Eustachian tube dilation or LET for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

et al. 2022

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“…The tests of ET function were performed at a stable ambient pressure and not under conditions of baro-challenge. Pressure chamber studies have been performed to explore ET ME pressure equalisation [Doyle et al, 2014;Meyer et al, 2018;Schwarz et al, 2019], but while valuable research tools, pressure chambers are not feasible instruments for routine clinical use.…”

Section: Limitationsmentioning

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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Correlation of Eustachian tube function with the results of type 1 tympanoplasty: a prospective study

Moneir

El-Kholy

Ali

et al. 2022

Eur Arch Otorhinolaryngol

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Objectives This study aims to evaluate Eustachian tube (ET) function tests and their impact on outcomes of tympanoplasty in patients with inactive chronic suppurative otitis media. Materials and methods A prospective study was conducted involving patients diagnosed with chronic suppurative otitis media (CSOM) and having a central dry perforation. Assessment of the ET function was done for all included cases by three tests; pressure swallow equalization test, saccharine test and methylene blue test. The primary outcome is the graft success rate defined as intact graft without any residual perforation at 6 months postoperatively. Secondary outcomes include hearing assessment and possible associated complications. Results 64 patients were included in the study with an average age of 36.59 ± 11.96 years. All patients underwent assessment of the ET function by saccharine test, methylene blue test and pressure equalization test (PET) followed by microscopic post-auricular tympanoplasty. Successful tympanoplasty is achieved in 93.75% of cases with residual perforation in four patients. Mean air–bone gap is significantly improved from 23.73 ± 2.80 preoperatively to 10.93 ± 5.46 postoperatively. Results of Methylene blue test has no statistical impact on graft take rate (p value = 0.379), while saccharine test and pressure equalization test results have statistically significant correlation with graft success (p value ≤ 0.001). Conclusions Saccharine and Pressure equalization tests have a good positive correlation with the graft healing in tympanoplasty, while methylene blue test was found to have no correlation with the success rate.

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Analyzing eustachian tube function in patients with symptoms of chronical Eustachian tube dysfunction by pressure chamber measurements

Cited by 12 publications

References 27 publications

A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

Eustachian Tube Function in Patients with Symptoms on Baro-Challenge

Correlation of Eustachian tube function with the results of type 1 tympanoplasty: a prospective study

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