Tubomanometry value as an associated factor for medication outcomes in adult acute otitis media with effusion

Abstract

Tubomanometry (TMM) is a relatively novel method for testing the eustachian tube (ET) function, which is speculated to be closely related to otitis media with effusion (OME). The purpose of this study is to explore the predictive power of TMM value for medication outcomes in adult acute OME. A cohort of 41 adult acute OME patients with 53 affected ears was studied retrospectively. All these patients completed a 2-week treatment including oral Myrtol Standardized Enteric capsules, nasal steroid, and oral antihistamine. The results showed that the response rate was 41.5% (22/53). The ratio of tympanometry C and TMM value differed significantly between responders and non-responders (P < 0.05), and the TMM value is the only predictive variable for treatment outcomes (P < 0.001, odds ratio 1.873). A ROC analysis of the TMM value for the treatment outcome showed that the area under the curve could achieve 0.773 (P < 0.001), while the optimal cutoff value calculated by Youden index was 1.5, with 72.7% sensitivity and 74.2% specificity. The response rate of ears with 2-6 TMM values could reach 66.7% (16/24), which was significantly higher than that of ears with TMM values 0-1, 20.7% (6/29) (P < 0.001). These findings showed that acute OME patients with a high TMM value and tympanometry C of the affected ear could potentially benefit from medication. The TMM value was an independent predictive factor of the treatment outcomes that could guide treatment decisions.

Medical Management for Eustachian Tube Dysfunction in Adults: A Systematic Review and Meta‐Analysis

“…Patients who had fluid behind the eardrum (Type B Tympanogram) were less likely to respond than those with retracted eardrums (Type C Tympanogram). 17,18 NonPharmacological Treatment. In two studies, the Politzer device was analyzed among 63 patients with subacute or duration-unspecified ETD and improved symptoms in 30% of cases.…”

“…Of the 12 studies included in our systematic review, 9 were quantitatively assessed with meta-analysis to analyze outcomes among 527 patients with ETD. Meta-analysis of weighted proportion for symptomatic improvement was conducted among five patient cohorts 17,18,29 and found that at ≤2 weeks follow-up, 50.3% (95% CI, 41.7-59.0) of patients improved with MM. Meta-analysis of continuous measures for ETDQ-7 resulted in À0.88 (95% CI, À1.12 to À0.64), favoring improvement of patient-reported scores.…”

“…Air-bone-gap (ABG) is a measurement of the difference between air-conduction and bone-conduction audiometric thresholds. Certain authors 17,18 defined an improvement in ABG of ≥10 dB as symptomatic improvement. Tympanometry, an electroacoustic measurement of the resistance of the tympanic membrane, is frequently used to detect abnormal ET function by grading outcome scores as normal (Type A) and abnormal (Type B or C).…”

“…Two nonrandomized studies assessing INCS in subacute ETD found improved symptomatic improvement in 42% to 56% of cases. 17,18 However, these results were pooled among patients receiving antihistamines and oral decongestants, obscuring the role of INCS in symptomatic improvement. In addition, only half of patients had improved outcomes, indicating that subacute ETD might or might not be responsive to treatment.…”

Methods of preoperative assessment of function of the auditory tube in patients with chronic tubotympanal purulent otitis media

“…В свою очередь, наличие разреженного воздуха и персистирующее воспаление в барабанной полости способствуют обструкции слуховой трубы, формируя порочный круг. Кроме того, отрицательное давление приводит к образованию ретракционного кармана барабанной перепонки, холестеатомы и последующей кондуктивной тугоухости [3][4].…”