Nasal septum deviation and Eustachian tube function: A prospective case-control study based on tympanometry, tubomanometry, and ETDQ-7

Prospective Evaluation of the Efficacy of Isolated Balloon Eustachian Tuboplasty: Short- and Medium-term Follow-up Results Based on Tubomanometry, ETDQ-7, Tympanometry, and Valsalva Maneuver

“…In our study, we focused mainly on the normalization of the subjective and objective measures evaluated, which can reduce and even underestimate the real effectiveness of the procedure: a significant improvement in complaints and objective measures can occur in patients with severe pathology at baseline, even if normalization does not occur. Therefore, some articles prefer to focus on improvement instead of normalization of measures and this may also explain the absence of a statistically significant correlation between both forms of effect measures evaluated in our study, which is in agreement with the study of diagnostic accuracy performed by Fontes Lima et al, 20 who concluded that the correlation between the ETDQ-7 and tympanometry and between the ETDQ-7 and TMM were weak. The incomplete agreement between the normalization of the ETDQ-7 and TMM can also be explained by the fact that some patients with only dysfunction of the ET opening at lower pressures (30 mbar) on TMM (mild dysfunction) may be totally asymptomatic.…”

“…Tympanometry remains the most frequently used test in most studies to objectively report ET function. Fontes Lima et al 20 showed that despite having a good specificity (92.6%) for the detection of ETD, its sensitivity is quite limited (61.1%) and therefore it is unsuitable and insufficient for excluding obstructive ETD, especially in patients with suspicious symptoms. Additionally, this test is also not appropriate for diagnosing intermittent ETD since middle ear pressure is highly variable throughout the day in these cases.…”

“…Thus, tubomanometry emerged as a tool with greater accuracy that also allows a quantitative assessment of ET function. Its high sensitivity (91.7% 20 ) allows the diagnosis of milder ETDs, especially in patients with classic symptoms but a normal TM exam and a type A tympanogram. Fontes Lima et al 20 concluded that when used alone, tympanometry is insufficient, ETDQ-7 may overestimate, and TMM is the most accurate of the three.…”

“…Its high sensitivity (91.7% 20 ) allows the diagnosis of milder ETDs, especially in patients with classic symptoms but a normal TM exam and a type A tympanogram. Fontes Lima et al 20 concluded that when used alone, tympanometry is insufficient, ETDQ-7 may overestimate, and TMM is the most accurate of the three. In this context, as none of them is completely reliable and representative of the real function of the ET, they are often used together in a complementary way to increase diagnostic sensitivity and specificity.…”

Tubomanometry correlations with patient characteristics and other diagnostic tests of Eustachian tube dysfunction: a cohort study of 432 ears

“…Potential contributing factors for OETD have been assumed to be smoking, chronic rhinosinusitis, allergic rhinitis, deviated septum, laryngopharyngeal reflux, and cleft palate. In one prospective study, patients with nasal septum deviation performance worse in TMM and their results improved after septoplasty [ 16 ]. An association between abnormal TMM and chronic rhinosinusitis and dust mite allergic rhinitis has been found [ 17 , 18 ].…”