Bae Seong Hoon, Moon Seojin, Jeong Mincheol, Moon In Seok
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul 03722, Korea.
Diagnostics (Basel). 2022 Mar 17;12(3):732. doi: 10.3390/diagnostics12030732.
The nine-step test is a classical method for evaluating Eustachian tube function. It directly assesses the patient's capacity to equilibrate middle ear pressure by swallowing. However, there are insufficient studies to appraise its diagnostic performance. The purpose of this study is to evaluate the sensitivity, specificity, and cut-off value of the nine-step test in patients with obstructive Eustachian tube dysfunction (oETD) and patulous Eustachian tube (PET). Enrolled subjects were divided into three groups. Control (50 ears of healthy volunteers), oETD (19 ears with oETD), and PET (29 ears with PET). Receiver operating characteristics curve analysis was conducted to evaluate the diagnostic performance of maximal peak pressure difference (ETTmd) in the nine-step test. Both the oETD group and the PET group showed decreased ETTmd. The nine-step test showed moderate accuracy when used to diagnose oETD (area under the curve = 0.875) and PET (area under the curve = 0.769). The highest diagnostic performance was observed when the cut-off value was 13 daPa for both the oETD group (sensitivity = 73.7%, specificity = 90.0%) and the PET group (sensitivity = 58.6%, specificity = 90.0%). The nine-step test has moderate diagnostic performance for oETD and PET.
九步测试是评估咽鼓管功能的经典方法。它通过吞咽直接评估患者平衡中耳压力的能力。然而，目前尚无足够的研究来评估其诊断性能。本研究的目的是评估九步测试在阻塞性咽鼓管功能障碍（oETD）和咽鼓管异常开放（PET）患者中的敏感性、特异性和临界值。纳入的受试者分为三组。对照组（50耳健康志愿者）、oETD组（19耳oETD患者）和PET组（29耳PET患者）。进行受试者操作特征曲线分析，以评估九步测试中最大峰值压差（ETTmd）的诊断性能。oETD组和PET组的ETTmd均降低。九步测试用于诊断oETD（曲线下面积=0.875）和PET（曲线下面积=0.769）时显示出中等准确性。当oETD组（敏感性=73.7%，特异性=90.0%）和PET组（敏感性=58.6%，特异性=90.0%）的临界值均为13 daPa时，观察到最高的诊断性能。九步测试对oETD和PET具有中等诊断性能。
