The Burden and Epidemiology of Eustachian Tube Dysfunction in Adults

Abstract

Objectives Pediatric eustachian tube dysfunction (ETD), otitis media with effusion (OME), and tympanic membrane retraction (TMR) have been well studied, but no large analyses have described the associated burden beyond childhood. The potential impact and feasibility of prospective trials designed to optimize management of affected adults are thus unclear. Our objectives were therefore (1) to determine the national visit burden associated with ETD/OME/TMR beyond childhood and (2) to examine risk factors specific to adults, highlighting differences in comparison with children. Study Design Cross-sectional analysis of a national database. Setting Ambulatory visits in the United States. Methods Epidemiologic analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (2005-2012) included data from 761,291 observations representing 9,369,388,092 visits. Chi-square test with Bonferroni adjustment for multiple comparisons was utilized for hypothesis testing. Results Visits related to ETD/OME/TMR exceeded 2 million per annum in patients 0 to 20 years of age (mean 2,625,965; range 2,239,288-3,329,858). Among those >20 years old, visits also exceeded 2 million (mean, 2,025,050; range, 1,550,669-2,353,799). Characteristics differed according to age: whereas ETD/OME/TMR affected more males <20 years, females were more frequently diagnosed in the older age group ( P < .0001). Patients >20 to 40 years of age were the most likely to visit the emergency department ( P = .0022). There were no statistically significant differences per season or region. The related diagnoses of cholesteatoma and chronic otitis media prompted additional visits. Conclusions ETD/OME/TMR is associated with a visit burden for adults that extends beyond childhood. Among adults, there may also be age-related differences in patient characteristics.

Evaluation of the Turkish version of the Eustachian Tube Dysfunction Questionnaire

“…Hence, ETD is blamed for the development of chronic otitis media, tympanic membrane retraction, and progression of the latter to chronic cholesteatomatous otitis media [10][11][12][13] and might affect the success rate of middle ear surgery. [14] Vila et al [15] reported that ETD is associated with 2 million visits per annum among those >20 years of age and 2.6 million visits among those <20 years. The cited authors revealed that the related diagnoses of ETD have a significant economic burden, and adequate knowledge of the pathophysiology of ETD and its suitable treatment may decrease the resourceintensive and significant economic burden.…”

Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery

“…Variables were dichotomized for the purpose of the case-control analysis. The cutoff points for ordinal and continuous variables were created using the MCID of the variables [5][6][7]9,10 or estimated based on the population distribution when no definition was available in the literature. Chi square test was utilized to compare categorical variables related to cases and controls.…”

“…2 The long-term effects of ETD can include communication difficulties and reduced productivity, both of which can contribute to a poorer quality of life reported by patients. [3][4][5] ETD has been widely recognized as an important comorbidity associated with CRS. Whereas others have used the 22-item Sino-Nasal Outcome test (SNOT-22) to assess the impact of CRS on quality of life, this validated questionnaire only contains a few ear-specific items.…”

Generic quality of life in persons with hearing loss: a systematic literature review

“…Hearing loss is present in nearly two thirds of adults aged 70 years and older in the U.S. population [ 5 ]. Even though most people with HL suffer from presbyacusis, other factors such as other ear diseases [ 6 ], occupational noise exposure [ 7 ] and specific genetic diseases [ 8 ] may cause HL. Thus, HL may affect people at all ages and stages in life [ 9 ].…”