Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis

Schilder, Anne G. M.; Bhutta, Mahmood F.; Butler, Christopher Collett; Holy, Chantal E.; Levine, Laurie; Kværner, Kari J.; Norman, Gill; Pennings, Ronald J.E.; Poe, Dennis S.; Silvola, Juha; Sudhoff, Holger; Lund, Valerie J.

doi:10.1111/coa.12475

Cited by 301 publications

(392 citation statements)

References 6 publications

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“…In patients with baro-challenge-induced ET dysfunction, by definition, no abnormalities are observed on otoscopy or tympanometry, which means that its diagnosis is based on patient-reported symptoms and the clinician's expert opinion [1] . Because of this lack of objective measures, a validated disease-specific instrument may help in discriminating between patients with ET dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion criteria for baro-challenge-induced obstructive ET dysfunction were history of aural fullness, popping in the ear or discomfort produced by ambient pressure changes; normal otoscopy, normal tympanometry, and normal liminal audiometry [1] . Symptoms had to be incapacitating and refractory to a 3-month empirical trial of topical nasal corticosteroids and oral antihistamines.…”

Section: Patient Groupmentioning

confidence: 99%

“…However, symptoms of aural fullness, popping, discomfort, or pain may only arise in case of ambient pressure changes, without abnormalities detected on otoscopy and tympanometry. This subtype is called baro-challenge-induced ET dysfunction [1] . Recently, balloon dilation Eustachian tuboplasty (BDET) has been demonstrated to be effective in 70% of a large cohort of patients affected by obstructive ET dysfunction [2,3] .…”

Section: Introductionmentioning

confidence: 99%

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Responsiveness of the 7-item Eustachian Tube Dysfunction Questionnaire

Roeyen

Heyning

Rompaey³

2016

Int Adv Otol

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OBJECTIVE:Baro-challenge-induced Eustachian tube (ET) dysfunction is defined as the presence of aural discomfort, popping, or pain, which only arises in case of ambient pressure changes, without abnormalities on otoscopy or tympanometry. Our primary aim was to determine the discriminative power of the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) in patients with baro-challenge-induced ET dysfunction in comparison with that in healthy controls. The secondary aim was to determine the responsiveness of ETDQ-7 in patients with baro-challenge-induced obstructive ET dysfunction who underwent balloon dilation tuboplasty (BDET). MATERIALS and METHODS:The accuracy of the diagnostic test was determined on the basis of the area under the curve in receiver-operating curve (ROC) analysis. Responsiveness to change of ETDQ-7 was assessed by exploring preoperative and postoperative ETDQ-7 scores using Cohen's kappa coefficient. Patients were asked whether their complaints improved, remained stable, or deteriorated after BDET. The findings of subjective evaluation were then compared with the difference in the ETDQ-7 score after BDET. RESULTS:In the baro-challenge-induced ET dysfunction group, the median preoperative total ETDQ-7 score was 26, decreasing to 16 after BDET. ROC analysis demonstrated excellent discriminative power for the baro-challenge-induced ET dysfunction group. Cohen's kappa coefficient was 0.633, indicating that there was substantial agreement between the ETDQ-7 values before and after BDET.CONCLUSION: ETDQ-7 can discriminate between patients with baro-challenge-induced ET dysfunction and healthy controls and can therefore be useful in its diagnosis. Furthermore the ETDQ-7 is responsive to change in patients with baro-challenge-induced ET dysfunction who have undergone BDET, although a larger sample size is required to confirm these preliminary findings.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Groupmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Responsiveness of the 7-item Eustachian Tube Dysfunction Questionnaire

Roeyen

Heyning

Rompaey³

2016

Int Adv Otol

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“…However, none has been found to be completely reliable and in clinical practice usually the diagnosis of ETD relies on patient's history and clinical examination combined with tympanometry 19 .…”

Section: Smoke and Eustachian Tube Functionmentioning

confidence: 99%

Effects of Smoking on Eustachian Tube and Hearing

Pezzoli¹,

Lofaro²,

Olivi³

et al. 2017

The International Tinnitus Journal

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Objective: The purpose of this study was to evaluate the effect of tobacco use on the Eustachian tube and inner ear function. Study Design: Case-control study. Subjects and settings: Thirty-one nonsmoking volunteers and 34 smoking subjects recruited in an University Hospital, submitted to an audiological evaluation including pure tone audiometry, basal tympanogram, stapedial reflexes analysis, and nine-step eustachian tube (ET) function test. Results: Pure Tone Average (PTA) threshold at all frequencies tested was 12.5 dB in smokers and 3.7 in nonsmoking subjects. Nine smokers (27%) presented some degree of hearing loss versus none in the nonsmoker group. Linear regression analysis showed a higher degree of sensorineural hearing loss with age in smokers. Among the smokers, 20 subjects (59%) presented an impaired tubal function for the nine-step inflation/deflation tympanometric test, while only 6 (19%) subjects in the group of nonsmokers showed a tubal dysfunction. Conclusion: Tobacco use may reduce the ability to hear, mainly causing a sensorineural hearing loss for higher frequencies. We also found the presence of a high number of smokers suffering from tubal dysfunction. This has an important clinical relevance, not only because smoking increases the incidence of middle ear diseases, but also because tubal dysfunction may cause nonspecific symptoms characterised by ear fullness and difficulties in middle ear equalisation.

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“…In rare cases, one-sided Eustachian tube dysfunction also manifests in vertigo, caused by a retraction of the ear drum, leading to the motion of the ossicles stimulation of the perilymph and endolymph of the cochlea, and further leading to an impairment of labyrinth function [6]. In most cases, dilatory tube dysfunction is a continuous problem [7]. The underlying factors for a dilatory tube dysfunction can be extrinsic, such as a nasopharyngeal mass obstruction of the pharyngeal Eustachian tube orifice or obstruction of the bony portion of the Eustachian tube [8].…”

Section: Case Report Discussionmentioning

confidence: 99%