Alper Cuneyt M, Teixeira Miriam S, Kim Jeehong H, Douglas Swarts J
Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Ave, Pittsburgh, PA, 15224, USA.
Department of Otolaryngology, University of Pittsburgh School Of Medicine, Pittsburgh, PA, USA.
Eur Arch Otorhinolaryngol. 2017 Apr;274(4):1865-1872. doi: 10.1007/s00405-016-4430-6. Epub 2016 Dec 21.
Tubomanometry is a relatively novel Eustachian tube (ET) function testing method. A number of recent studies have utilized the R value of Tubomanometry as the main objective measure in reporting their outcome in balloon dilation of ET. There is, however, a lack of evidence concerning the reliability or validity of Tubomanometry measurements. The objectives of this study are to determine the accuracy of Tubomanometry for detecting ET opening as compared to tympanometry and determine its usefulness as a measure of ET function. Healthy subjects between ages 8 and 76 years with an intact tympanic membrane and no middle ear (ME) effusion were prospectively tested. Primary outcomes were the ET opening as determined by the Tubomanometry R value and the increase in ME pressure with tympanometry-measured in relation to a swallow at a nasopharyngeal pressure of 300 daPa. The accuracy of the tubomanometry R value for identifying a successful ET opening was made in reference to the change of ME pressure. A total of 280 measurements were available from 258 ears in 137 subjects. The presence of tubomanometry R value showed high sensitivity of detecting ET opening for the criteria of >5 daPa ME pressure increase (187/202) but low specificity for detecting ET non-opening (34/78). The R value criterion described in the original manuscripts on Tubomanometry is sensitive but not specific for ET opening. The need for validation of the tubomanometry test obviates its use as the main objective outcome measure for the balloon dilation of ET procedure.
咽鼓管压力测量法是一种相对新颖的咽鼓管（ET）功能测试方法。最近的一些研究将咽鼓管压力测量法的R值作为主要客观指标来报告其在咽鼓管球囊扩张术的结果。然而，关于咽鼓管压力测量法测量的可靠性或有效性缺乏证据。本研究的目的是确定与鼓室导抗测量法相比，咽鼓管压力测量法检测咽鼓管开放的准确性，并确定其作为咽鼓管功能测量指标的有用性。对年龄在8至76岁之间、鼓膜完整且无中耳（ME）积液的健康受试者进行前瞻性测试。主要结果是通过咽鼓管压力测量法的R值确定的咽鼓管开放情况，以及在鼻咽压力为300 daPa时，与吞咽相关的鼓室导抗测量法测量的中耳压力增加情况。根据中耳压力的变化确定咽鼓管压力测量法R值识别成功的咽鼓管开放的准确性。共有来自137名受试者258只耳朵的280次测量数据。咽鼓管压力测量法R值的存在显示，对于中耳压力增加>5 daPa的标准，检测咽鼓管开放具有高敏感性（187/202），但检测咽鼓管未开放的特异性较低（34/78）。原始咽鼓管压力测量法手稿中描述的R值标准对咽鼓管开放敏感但不具有特异性。咽鼓管压力测量测试需要验证，这排除了其作为咽鼓管球囊扩张术主要客观结果指标的用途。
