Schröder S, Lehmann M, Korbmacher D, Sauzet O, Sudhoff H, Ebmeyer J
Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Academic Teaching Hospital University of Münster, Bielefeld, Germany.
Epidemiology and International Public Health, School of Public health, Bielefeld University, Bielefeld, Germany.
Clin Otolaryngol. 2015 Dec;40(6):691-7. doi: 10.1111/coa.12451.
The objective of this study was to demonstrate the reliability of tubomanometry (TMM) described by Estéve in the diagnosis of chronic obstructive Eustachian tube (ET) dysfunction.
Combined prospective and retrospective clinical study.
Tertiary referral centre, affiliated to university.
Two hundred and fifteen healthy subjects were examined once, 25 healthy subjects underwent TMM weekly for 6 weeks, and six healthy subjects were tested three times a day on at least three different days. The results of tubomanometry in healthy subjects were compared to data obtained from 171 patients with chronic obstructive ET dysfunction.
In healthy subjects, there was an immediate opening of the ET at 30-50 mbar with an R-value ≤ 1 in at least 94% of the cases. In patients with chronic ET dysfunction, an opening of the ET could be registered in only 42% of patients at 30 mbar and in 58% at 50 mbar. The average of the R-value in these subjects always indicated towards a delayed opening (R > 1). When measurements are repeated in the same subject with a weekly interval, the intraclass correlation (ICC) was 0.49 for the TMM with 30 mbar, 0.51 for the TMM with 40 mbar and 0.52 for the TMM with 50 mbar in healthy people. For the patients with symptoms of ET dysfunction, the ICC for up to four repeated measures was 0.50 for the TMM with 30 mbar, 0.53 for the TMM with 40 mbar and 0.54 for the TMM with 50 mbar. A complete agreement of the results in repeated measurements within seconds was present in 86% for 30 and 40 mbar and in 79% for 50 mbar. The ICC was 0.61 for the TMM with 50 mbar, 0.62 for the TMM with 40 mbar and 0.68 for the TMM with 30 mbar.
Tubomanometry can support the diagnosis of ET dysfunction. An R-value ≤ 1 indicates a regular function of the ET, an R-value >1 indicates a delayed opening of the ET, and no definable R-value means no detectable opening of the ET. TMM is a reliable and valid instrument to support the diagnosis of chronic obstructive ET dysfunction.
本研究的目的是证明埃斯特韦所描述的咽鼓管压力测量法（TMM）在诊断慢性阻塞性咽鼓管（ET）功能障碍方面的可靠性。
前瞻性与回顾性相结合的临床研究。
隶属于大学的三级转诊中心。
对215名健康受试者进行一次检查，25名健康受试者每周进行一次TMM检查，共6周，6名健康受试者在至少三个不同的日子里每天进行三次测试。将健康受试者的咽鼓管压力测量结果与171例慢性阻塞性ET功能障碍患者的数据进行比较。
在健康受试者中，至少94%的病例在30 - 50毫巴时咽鼓管立即开放，R值≤1。在慢性ET功能障碍患者中，只有42%的患者在30毫巴时咽鼓管可记录到开放，58%的患者在50毫巴时可记录到开放。这些受试者的R值平均值总是表明开放延迟（R > 1）。当在同一受试者中每周重复测量时，健康人群中30毫巴的TMM组内相关系数（ICC）为0.49，40毫巴的TMM为0.51，50毫巴的TMM为0.52。对于有ET功能障碍症状的患者，30毫巴的TMM在多达四次重复测量时的ICC为0.50，40毫巴的TMM为0.53，50毫巴的TMM为0.54。30和40毫巴时，86%的重复测量结果在数秒内完全一致，50毫巴时为79%。50毫巴的TMM组内相关系数为0.61，40毫巴的TMM为0.62，30毫巴的TMM为0.68。
咽鼓管压力测量法可辅助诊断ET功能障碍。R值≤1表明ET功能正常，R值>1表明ET开放延迟，无明确R值意味着未检测到ET开放。TMM是辅助诊断慢性阻塞性ET功能障碍的可靠且有效的工具。
