Tests of Eustachian Tube Function: the Effect of Testing Technique on Tube Opening in Healthy Ears

Smith, Matthew; Blythe, Andrew J. C.; Baker, Charlotte A.; Zou, Charlie C.; Hutchinson, Peter J.; Tysome, James R.

doi:10.1097/mao.0000000000001375

Cited by 22 publications

(12 citation statements)

References 23 publications

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“…This study builds on previous work to identify the most useful ET function tests in terms of reliability and accuracy[ 9 , 10 ]. Given the potential issues with the flawed nature of the expert panel reference it appears that the results from the latent class models are more reliable, where tympanometry, sonotubometry and tubomanometry had the highest Youden’s index and therefore greatest potential diagnostic value for OETD.…”

Section: Discussionmentioning

confidence: 95%

“…If this is the case, observed Valsalva has the best diagnostic performance of the tests not requiring specialist equipment. This test does however have certain disadvantages, the main one being a high degree of variation between patients regarding the nasopharyngeal pressure generated, even following training, that has been shown to affect the rate of ET opening and therefore test outcome[ 9 , 10 ]. Observed Valsalva also only tests passive ET opening, therefore potentially missing individuals with OETD due to failure of active ET opening.…”

Section: Discussionmentioning

confidence: 99%

“…Two forms of ET function test were assessed as index tests: objective and semi-objective measures of ET opening, and symptom-based PROMS. Tests of ET opening for OETD (9 tests) and PETD (5 tests) were performed according to optimal methods previously identified[ 9 , 10 ] or standard procedure (PETD tests). Details of the tests of ET opening, their various methods and the repeats performed can be found in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Raw test data were initially analysed using descriptive statistics in accordance with diagnostic criteria described in the literature and previous work[ 9 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Raw test data were initially analysed using descriptive statistics in accordance with diagnostic criteria described in the literature and previous work[ 9 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2018

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“…The second evaluation of eustachian tube patency was an automatic eustachian function test that was quickly conducted with tympanometry (EFT1). This test automatically evaluates eustachian tube function using a combination of Valsalva and Toynbee maneuvers and can be conducted using most currently available tympanometry devices for effective evaluation of the eustachian tube [6,15]. The study group and especially the players of woodwind instruments had statistically more nonpatent eustachian tubes.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Middle-Ear Resonance Frequency and Eustachian Tube Function in Players of Wind Instruments

Özer¹,

Özer²,

Erbek³

et al. 2021

Folia Phoniatr Logop

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Introduction: The effect of the continuous forced expiration action of players of wind instruments to produce sound, on the eustachian tube functions and the middle-ear resonance frequency (RF), has not been investigated in the literature to date. The aim of this study is to evaluate eustachian tube functions and the middle-ear RF of players of wind instruments. Methods: In this prospective case-control clinical study, a study group of 28 players of wind instruments in the orchestra (28 participants, 56 ears) and a control group of 34 volunteers (34 participants, 68 ears) were included. The eustachian function of wind instrument players in a symphony orchestra was measured using an automatic eustachian tube function test in acoustic tympanometry and the RF of the middle ear was determined in multifrequency tympanometry. Results: There was a statistically significant difference among the musicians, especially in players of woodwind instruments, in terms of dysfunction of the eustachian tubes (p = 0.048). In the musicians, the pre- and postperformance RF mean values for all ears were 925 and 1,020 Hz, respectively, and these were significantly different (p = 0.004). Conclusion: This is the first study to uses multifrequency tympanometry to examine the middle-ear RF and eustachian tube function of wind instrument musicians in an orchestra. Eustachian tube dysfunction was found to be more prominent and a higher RF of the middle ear was seen after a performance, especially in players of wood wind instruments. However, the effect of these on the professional performance of players of wind instruments should be investigated in future work.

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Assessing the usefulness of tubomanometry as a diagnostic tool in Eustachian tube dysfunction

Herrera,

Miranda,

Villarreal

et al. 2024

Eur Arch Otorhinolaryngol

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Tests of Eustachian Tube Function: the Effect of Testing Technique on Tube Opening in Healthy Ears

Cited by 22 publications

References 23 publications

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

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

Middle-Ear Resonance Frequency and Eustachian Tube Function in Players of Wind Instruments

Assessing the usefulness of tubomanometry as a diagnostic tool in Eustachian tube dysfunction

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