Association of a standardized measure of nasopharyngeal inflammation with Eustachian tube dysfunction questionnaire score

Abstract

Background: Standardized diagnostic criteria for Eustachian tube (ET) dysfunction (ETD) have not been established. The purpose of this study was to characterize the relationship between ET inflammation and ETD symptoms and to determine the diagnostic performance of a quantitative score. Methods: Patients were enrolled in a rhinology clinic between October 2018 and June 2019. Patients underwent nasal endoscopy and completed the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Nasopharyngeal inflammation identified on endoscopy was quantified using the Endoscopic Evaluation of the Eustachian Tube (3ET) score. Tympanometry was performed as indicated.Comorbid conditions were assigned during the patient encounter. Results: A total of 414 patients were included in the study. Patients with clinically significant ETD symptoms (ETDQ-7 ≥2.1) had higher 3ET scores than those without symptoms. A 1-point increase in 3ET score was associated with a 1.7-fold increase in odds of clinically significant ETD symptoms (adjusted OR [aOR], 1.72; 95% CI, 1.46 to 2.05). The 3ET scores were correlated with ETDQ-7 scores (ρ = 0.54) and 22-item Sino-Nasal Outcome Test (SNOT-22) scores (ρ = 0.52). 3ET scores were not associated with tympanometric peak pressures. Patients with ETD symptoms were more likely to have laryngopharyngeal reflux (aOR, 2.71; 95% CI, 1.24 to 6.18). A 3ET score of 4 predicted symptomatic state in 80% of cases with a specificity of 97.8% and positive predictive value of 96.6%. Conclusion: Inflammatory findings at the nasopharyngeal ET orifice are associated with clinically significant ETD symptoms. The 3ET score is specific for a symptomatic state and has potential clinical utility in the evaluation of suspected ETD. ©2021 ARSAAOA, LLC.

Digestive Biomarkers of Laryngopharyngeal Reflux: A Preliminary Prospective Controlled Study

“…The results of this preliminary study may lead to the development of new basic science studies investigating the potential toxicity of elastase on mucosa cells of the upper aerodigestive tract. Such research may be useful for many otolaryngological conditions where LPR is involved, including vocal fold benign lesions, 29 chronic pharyngitis, 30 chronic rhinosinusitis, 31 otitis media, 32 Eustachian tube dysfunction, 33 or primary burning mouth syndrome 34 …”

Year in review: 2021 IFAR article summary

“…Pan et al 49 evaluated change in nasalance scores in patients with CRS using oral passage, mixed passage, and nasal sentences and demonstrated that patients with severe disease and higher polyp grade had lower nasalance scores. Bergeron et al 50 demonstrated an association between inflammatory findings at the nasopharyngeal Eustachian tube orifice and clinically significant Eustachian tube dysfunction symptoms.…”