A New Test of Eustachian Tube Function with Otoadmittance Meter: Tubotympanometry

Morimitsu, Tamotsu; Enatsu, Kaori; Matsumoto, Ichiro; Ushisako, Yasuaki

doi:10.3109/00016488109138501

Cited by 7 publications

(9 citation statements)

References 4 publications

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“…Only 1 other published account of the continuous impedance technique for ET testing could be found, with a Valsalva-associated ET opening rate of 93% in healthy ears. 7 Most middle ear pressure changes appeared to persist beyond the applied nasopharyngeal pressure, with similar findings in both tests. The persistence is due to trapping of pressure within the middle ear, in the absence of swallowing to actively open the ET.…”

Section: Discussionsupporting

confidence: 60%

“…Only 1 other published account of the continuous impedance technique for ET testing could be found, with a Valsalva-associated ET opening rate of 93% in healthy ears. 7 In comparison, in our tuboimpedance data, using the standard tubomanometry pressures of 30, 40, and 50 mbar, 100% of tests resulted in detection of ET opening. This increase in opening detection over Valsalva testing is likely due to the combined active and passive ET opening occurring with both paratubal muscle contractions and a large positive pressure differential across the ET.…”

Section: Discussionmentioning

confidence: 99%

“…Impedance was measured in units of equivalent volume of air in milliliters, 10 and a positive deflection from baseline ≥0.05 mL was considered positive for ET opening. 7 For tubomanometry, a positive EAC pressure increase greater than 0.1 mbar was recorded as an opening. Based on the shape of the pressure or impedance traces, recordings were assigned to 1 of 2 groups: persistent or nonpersistent middle ear pressure.…”

Section: Methodsmentioning

confidence: 99%

“…Unlike external auditory canal (EAC) manometry, the use of continuous impedance assessment has been not been commonly used to assess ET opening 7 .…”

Section: Tubomanometry Has Established Itself As a Test Of Et Functiomentioning

confidence: 99%

“…Unlike EAC manometry, the use of continuous impedance assessment has not been commonly used to assess ET opening. 7 We have investigated the feasibility of performing continuous impedance recording using the tubomanometry method of inducing metered nasopharyngeal pressures in time with swallowing (ie, ''tuboimpedance''). As a first investigation into this new technique, the detected ET opening rate and the repeatability of this method using immediate and delayed repeats in healthy ears are compared with paired tubomanometry results.…”

mentioning

confidence: 99%

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Tuboimpedance: A New Test of Eustachian Tube Function

Smith

Zou

Blythe

et al. 2017

Otolaryngol.--head neck surg.

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Objective Eustachian tube (ET) dysfunction is most frequently caused by a failure of the ET to adequately open; however, there is currently no reliable method of assessing this. Tubomanometry has recently shown good interindividual repeatability as a measure of ET function by measuring middle ear pressure after the application of regulated nasopharyngeal pressures during swallowing. We present the first reports of a novel test: middle ear impedance measurements during standard nasopharyngeal pressure application (tuboimpedance). We assess repeatability in healthy ears and any advantages over tubomanometry. Study Design Exploratory cohort diagnosis study. Setting Tertiary referral center. Subjects Twenty screened, healthy ears (10 volunteers). Methods Tubomanometry and tuboimpedance tests were performed while individuals swallowed with applied nasopharyngeal pressures of 20, 30, 40, and 50 mbar. Eustachian tube opening detection rate and test repeatability (measured by intraclass correlation coefficient [ICC]) for immediate and delayed repeats at each pressure were compared. Results ET opening was detected more frequently using tuboimpedance, with a 100% detection rate using a nasopharyngeal pressure of 30 mbar or more, compared to 88% to 96% with tubomanometry. Detection of ET opening at 20 mbar was possible with tuboimpedance. Repeatability of both tests was mostly strong (ICC >0.7) for both immediate and delayed repeats. Repeatability for the tubomanometry R value was only fair to moderate. Conclusion Tuboimpedance may provide a repeatable measure of ET opening that is easier to perform due to lower nasopharyngeal pressures required and fewer issues with poor ear-probe sealing. Further assessment in patients with different forms of ET dysfunction is required.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Unlike external auditory canal (EAC) manometry, the use of continuous impedance assessment has been not been commonly used to assess ET opening 7 .…”

Section: Tubomanometry Has Established Itself As a Test Of Et Functiomentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Tuboimpedance: A New Test of Eustachian Tube Function

Smith

Zou

Blythe

et al. 2017

Otolaryngol.--head neck surg.

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The effects of anesthesia of the tympanic membrane on eustachian tube function

Nagai

Nagata

et al. 1989

Arch Otorhinolaryngol

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In our previous histological studies of the tympanic membrane, we reported the presence of encapsulated nerve corpuscles that are capable of detecting middle ear pressure. Based on these findings, the relation between sensory receptors in the tympanic membrane and tubal function was examined in a clinical study. Tubal function was tested during Valsalva maneuvers and its active equilibration. Function was recorded as a change of the static compliance of the tympanic membrane on an otoadmittance meter. To paralyze the sensory receptors in the tympanic membrane, iontophoresis was used to induce anesthesia of the drum. Forty ears of 20 subjects were tested. All ears were able to equalize positive middle ear pressure without or with a single swallowing. After anesthesia, 13 ears needed more than two swallows and 4 ears failed to equalize middle ear pressure in spite of repeated swallowings. As eustachian tube function changed following anesthesia of the tympanic membranes, a neural connection between sensory receptors in the tympanic membrane and tubal muscles is suggested.

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Eustachian tube function test: a new dimension in the management of CSOM

Biswas

1999

IJO & HNS

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A New Test of Eustachian Tube Function with Otoadmittance Meter: Tubotympanometry

Cited by 7 publications

References 4 publications

Tuboimpedance: A New Test of Eustachian Tube Function

Tuboimpedance: A New Test of Eustachian Tube Function

The effects of anesthesia of the tympanic membrane on eustachian tube function

Eustachian tube function test: a new dimension in the management of CSOM

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