Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, Carretera del Molino 2, Fuenlabrada, 28942, Madrid, Spain.
Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario La Zarzuela, Madrid, Spain.
Eur Arch Otorhinolaryngol. 2024 Oct;281(10):5135-5143. doi: 10.1007/s00405-024-08724-8. Epub 2024 May 29.
This study aims to evaluate the validity and reliability of tubomanometry (TMM) in diagnosing obstructive Eustachian tube dysfunction (OETD) before balloon Eustachian tuboplasty (BET).
A prospective cohort study was conducted, involving 25 patients with sinonasal pathology, 75 patients with middle ear disease, and 25 healthy subjects, totaling 250 ears. All participants underwent comprehensive physical examinations, including TMM, nasal videoendoscopy, otoendoscopy, Valsalva maneuver (VM), tympanometry, and audiometry. Additionally, various scales such as ETDQ-7 and ETS-7 were employed. Tympanometry served as the gold standard for assessing OETD, and comparisons were made among the measures across the three groups.
Among the 125 participants, 44.8% (n = 56) were female, and 55.2% (n = 69) were male, with ages ranging from 19 to 93 years (M = 48.5; SD = 15.6). In our study, VM demonstrated high sensitivity (86.3%) when tympanometry was considered the gold standard. Conversely, TMM, ETDQ-7, and ETS-7 exhibited high specificity, with ETDQ-7 showing the highest specificity (87.4%). Regarding TMM, all R values in patients within the middle ear disease group were pathological (R > 1).
TMM has exhibited notable specificity as a diagnostic tool compared to tympanogram and VM. Nonetheless, the combination of TMM and ETDQ-7 has enabled us to conduct a diagnostic assessment with high sensitivity and specificity for chronic OETD diagnosis.
本研究旨在评估 Tubomanometry（TMM）在球囊咽鼓管成形术（BET）前诊断阻塞性咽鼓管功能障碍（OETD）的有效性和可靠性。
进行了一项前瞻性队列研究，纳入了 25 例鼻-鼻窦疾病患者、75 例中耳疾病患者和 25 例健康受试者，共计 250 只耳朵。所有参与者均接受了全面的体格检查，包括 TMM、鼻内镜检查、耳内镜检查、瓦尔萨尔瓦动作（VM）、鼓室图检查和听力检查。此外，还使用了 ETDQ-7 和 ETS-7 等各种量表。鼓室图检查被用作评估 OETD 的金标准，并对三组之间的各项测量值进行了比较。
在 125 名参与者中，44.8%（n=56）为女性，55.2%（n=69）为男性，年龄为 19 至 93 岁（M=48.5；SD=15.6）。在我们的研究中，当以鼓室图检查为金标准时，VM 表现出了较高的敏感性（86.3%）。相反，TMM、ETDQ-7 和 ETS-7 则表现出了较高的特异性，其中 ETDQ-7 的特异性最高（87.4%）。就 TMM 而言，中耳疾病组中所有患者的 R 值均为病理性（R>1）。
与鼓室图和 VM 相比，TMM 作为一种诊断工具具有显著的特异性。然而，TMM 和 ETDQ-7 的结合使我们能够进行诊断评估，具有较高的敏感性和特异性，有助于慢性 OETD 的诊断。
