Quantitative Description of Eustachian Tube Movements During Swallowing as Visualized by Transnasal Videoendoscopy

Alper, Cüneyt M.; Teixeira, Miriam S.; Swarts, J. Douglas; Doyle, William J.

doi:10.1001/jamaoto.2014.3002

Cited by 22 publications

(42 citation statements)

References 22 publications

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“…New treatments for nonpatulous ETD, including balloon dilation, have generated renewed interest in the pathophysiology, treatment options, and prognosis for these patients . Recent advances in diagnostic evaluation include a more rigorous evaluation and nuanced understanding of the eustachian tube orifice anatomy and dynamic function via nasal endoscopy, as well as more research‐related diagnostic tests such as sonotubometry, tubomanometry, pressure chamber test, and inflation‐deflation test . The ETDQ‐7 is a recently developed tool that more thoroughly and reproducibly evaluates ETD symptoms.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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Objectives/Hypothesis Ear fullness and pressure is a common complaint seen in otolaryngology clinics and frequently is attributed to eustachian tube dysfunction (ETD). In addition to traditional tympanometry and physical examination, the seven‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) has recently been used to aid in the diagnosis of ETD and to assess its severity. Temporomandibular joint disorder (TMJD) is a common condition that causes similar symptoms to ETD and has been recognized as a potential confounding condition in patients presenting with ETD symptoms. We sought to determine the cross‐sectional prevalence of ETD symptoms in patients with TMJD using the ETDQ‐7. Study Design Prospective cross‐sectional analysis. Methods An analysis was performed of ETDQ‐7 scores in patients diagnosed with TMJD. Results A total of 21 patients with confirmed TMJD completed the ETDQ‐7 at routine consult or follow‐up for their TMJD. The mean ± standard deviation ETDQ‐7 score for the cohort was 24.5 ± 12.5. Two‐thirds of patients had an ETDQ‐7 score of >14.5, which has been used in the literature to denote clinically significant ETD. No single question was scored significantly higher than the others. Conclusions Symptoms of ETD are highly prevalent among patients with TMJD determined by patient‐reported outcome measures. It is not clear if these symptoms reflect true derangement of eustachian tube function in these patients or whether there is only clinical similarity between ETD and TMJD. However, future research efforts may resolve this dilemma. Level of Evidence 4 Laryngoscope, 130:E233–E236, 2020

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Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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“…Combining functional information from sonotubometry and endoscopic evaluation is reported to improve the accuracy of each of these tools . Recent reports of a more detailed quantitative description of peritubal movements and the shape and magnitude of the transferred sound allow a more sophisticated analysis of the ET function during swallowing …”

Section: Discussionmentioning

confidence: 99%

“…A recent report compared the angular and spatial changes of the ET nasopharyngeal anatomical structures during swallowing between subjects with or without a history of significant middle ear disease as indicated by ventilation tube insertion . That study provided insight into the factors underlying the effectiveness of swallowing for ET dilation.…”

Section: Discussionmentioning

confidence: 99%

“…The data available for analysis were the video recording of the ET component movements and synchronous microphone signals over the swallow time for each of the three swallows of the 33 subjects. Previously, using a subset of these data, we developed and reported procedural methods to parameterize the sonotubometric microphone signal envelope and to quantify the ET component movements captured by videoendoscopy throughout a swallow. These procedures were followed, and the data from the two sources were abstracted independently by two investigators and then reconciled.…”

Section: Methodsmentioning

confidence: 99%

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Correlations between videoendoscopy and sonotubometry of eustachian tube opening during a swallow

2016

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Objective Describe the relationship between the magnitude of Eustachian tube (ET) dilation during swallowing observed on trans-nasal videoendoscopy and quantified by sonotubometry. Study Design Descriptive observational study Methods Simultaneous trans-nasal videoendoscopic and sonotubometric recordings were done on 33 adults with no middle-ear disease. Briefly, microphones were placed in the ear-canals, a 45° telescope introduced through one side of the nose to visualize and record ipsilateral ET movements, and the probe from a sound generator placed in the opposite nostril. At a generated nasopharyngeal sound-level, ET movements and ipsilateral microphone signals were continuously recorded while the subject performed a series of 3 swallows. For each swallow, relational movements among ET structures observed on video-recordings and characteristics of the sonotubometry signal envelope at the ear-canal were quantified at 3 times, swallow onset (T1), maximum soft-palate elevation (T2), and maximum ET luminal dilation (T3). Results A total of 99 swallows were analyzed. The average medial rotation of the ET cartilage and lateral wall over the T1-T2 interval were −32.7±14.9° and 7.2±25.1°, and over the T2-T3 were 4.6±7.7° and 6.2±14.6°, respectively. The trans-tubal sound transmission during a swallow peaked at an amplitude of 30.5±35.7 mV during the 572.5±292.6 msec of elevated sound-pressure time. Correlational analysis documented significant linear associations between the relational measures of ET component movements from videoendoscopy and the signal envelope measures from sonotubometry. Conclusion There is a direct linear relationship between the degree of ET luminal dilation visualized on videoendoscopy and represented in the sonotubometry signal envelope.

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“…34 Alper et al described a new frame-by-frame videoendoscopic image analysis in which reference points and angle displacements capture the ET opening mechanics during swallows. 35 Casselbrant et al evaluated the ability of FRT to discriminate between 3-year-olds with recurrent acute OM (rAOM) or chronic OM with effusion (cOME) and found that although the passive and active resistances were different, the rates of tubal constriction were similar. 36 More recently, in a crosssectional study of 3-and 4-year-olds with patent tympanostomy tube (TT) and a history of rAOM or cOME, the authors found no difference in FRT parameters.…”

Section: Physiology Pathophysiology and Testingmentioning

confidence: 99%

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid—Anatomy, Physiology, Pathophysiology, and Pathogenesis)

Alper

Luntz

Takahashi

et al. 2017

Otolaryngol.--head neck surg.

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Objective. In this report, we review the recent literature (ie, past 4 years) to identify advances in our understanding of the middle ear-mastoid-eustachian tube system. We use this review to determine whether the short-term goals elaborated in the last report were achieved, and we propose updated goals to guide future otitis media research.Data Sources. PubMed, Web of Science, Medline.Review Methods. The panel topic was subdivided, and each contributor performed a literature search within the given time frame. The keywords searched included middle ear, eustachian tube, and mastoid for their intersection with anatomy, physiology, pathophysiology, and pathology. Preliminary reports from each panel member were consolidated and discussed when the panel met on June 11, 2015. At that meeting, the progress was evaluated and new short-term goals proposed.Conclusions. Progress was made on 13 of the 20 short-term goals proposed in 2011. Significant advances were made in the characterization of middle ear gas exchange pathways, modeling eustachian tube function, and preliminary testing of treatments for eustachian tube dysfunction.Implications for Practice. In the future, imaging technologies should be developed to noninvasively assess middle ear/eustachian tube structure and physiology with respect to their role in otitis media pathogenesis. The new data derived from these structure/function experiments should be integrated into computational models that can then be used to develop specific hypotheses concerning otitis media pathogenesis and persistence. Finally, rigorous studies on medical or surgical treatments for eustachian tube dysfunction should be undertaken.

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Quantitative Description of Eustachian Tube Movements During Swallowing as Visualized by Transnasal Videoendoscopy

Cited by 22 publications

References 22 publications

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

Correlations between videoendoscopy and sonotubometry of eustachian tube opening during a swallow

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid—Anatomy, Physiology, Pathophysiology, and Pathogenesis)

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