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European Archives of Oto-Rhino-Laryngology

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29.05.2023 | Review Article

Assessment of the Eustachian tube: a review

verfasst von: Shanshan Liu, Xin Ni, Jie Zhang

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 9/2023

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Abstract

Background

Dysfunction of the Eustachian tube (ET) can lead to negative pressure within the middle ear, which, in turn, causes various pathological changes. Multiple testing methods for ET function have been devised, each with its own advantages and disadvantages. Knowing the characteristics of each ET function test and the unique characteristics of ET dysfunction (ETD) in children are prerequisites for choosing the optimal assessment method. For a comprehensive diagnosis, assessment should also include the localisation of any sites of obstruction. This review aims to summarise the methods of evaluating ET function and locating sites of ET lesions.

Methods

Articles evaluating ET function, localising lesions in the ET, and ETD in children were collected from the PubMed database. We selected only relevant English publications.

Results

ETD in children has different characteristics to those in adults. The appropriate tests for assessing ET function depend on the specific conditions of the individual patient. Valsalva computed tomography can provide information on the soft and bony anatomy of the ET to facilitate identification of lesion sites.

Conclusion

An accurate diagnosis should be based on a combined analysis of objective and subjective results, with interpretation made in conjunction with clinical history and physical examination. A comprehensive assessment should include lesion localisation. When assessing ETD in children, it is important to take into account the characteristics of this population.

Doyle WJ (2017) A formal description of middle ear pressure-regulation. Hear Res 354:73–85. https://doi.org/10.1016/j.heares.2017.08.005CrossRefPubMedPubMedCentral

Tos M, Stangerup SE, Holm-Jensen S, Sorensen CH (1984) Spontaneous course of secretory otitis and changes of the eardrum. Arch Otolaryngol 110(5):281–289. https://doi.org/10.1001/archotol.1984.00800310005002CrossRefPubMed

Sade J (1993) Atelectatic tympanic membrane: histologic study. Ann Otol Rhinol Laryngol 102(9):712–716. https://doi.org/10.1177/000348949310200912CrossRefPubMed

Ars B, De Craemer W, Ars-Piret N (1989) The lamina propria and cholesteatoma. Clin Otolaryngol Allied Sci 14(5):471–475. https://doi.org/10.1111/j.1365-2273.1989.tb00406.xCrossRefPubMed

Robinson SR, Thompson S, Allen JB (2016) Effects of negative middle ear pressure on wideband acoustic immittance in normal-hearing adults. Ear Hear 37(4):452–464. https://doi.org/10.1097/AUD.0000000000000280CrossRefPubMed

Tos M (1998) Importance of eustachian tube function in middle ear surgery. Ear Nose Throat J 77(9):744–747CrossRefPubMed

Llewellyn A, Norman G, Harden M, Coatesworth A, Kimberling D, Schilder A et al (2014) Interventions for adult Eustachian tube dysfunction: a systematic review. Health Technol Assess. 18(46):1–180. https://doi.org/10.3310/hta18460CrossRefPubMedPubMedCentral

Schilder AG, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ et al (2015) Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 40(5):407–411. https://doi.org/10.1111/coa.12475CrossRefPubMedPubMedCentral

Smith ME, Bance ML, Tysome JR (2019) Advances in Eustachian tube function testing. World J Otorhinolaryngol Head Neck Surg 5(3):131–136. https://doi.org/10.1016/j.wjorl.2019.08.002CrossRefPubMedPubMedCentral

10.

Sproat R, Burgess C, Lancaster T, Martinez-Devesa P (2014) Eustachian tube dysfunction in adults. BMJ 348:g1647. https://doi.org/10.1136/bmj.g1647CrossRefPubMed

11.

Feldman AS (1976) Tympanometry: application and interpretation. Ann Otol Rhinol Laryngol 85(2 Suppl 25 Pt 2):202–208. https://doi.org/10.1177/00034894760850S238CrossRefPubMed

12.

Terkildsein K, Thomsen KA (1959) The influence of pressure variations on the impedance of the human ear drum. A method for objective determination of the middle-ear pressure. J Laryngol Otol. 73:409–418. https://doi.org/10.1017/s002221510005550xCrossRefPubMed

13.

Bredfeldt RC (1991) An introduction to tympanometry. Am Fam Physician 44(6):2113–2118PubMed

14.

Jerger J, Jerger S, Mauldin L (1972) Studies in impedance audiometry. I. Normal and sensorineural ears. Arch Otolaryngol. 96(6):513–523. https://doi.org/10.1001/archotol.1972.00770090791004CrossRefPubMed

15.

Buckingham RA, Ferrer JL (1973) Middle ear pressures in eustachian tube malfunction: manometric studies. Laryngoscope 83(10):1585–1593. https://doi.org/10.1288/00005537-197310000-00002CrossRefPubMed

16.

Renvall U, Holmquist J (1976) Tympanometry revealing middle ear pathology. Ann Otol Rhinol Laryngol 85(2 Suppl 25 Pt 2):209–215. https://doi.org/10.1177/00034894760850S239CrossRefPubMed

17.

Cinamon U, Sade J (2003) Tympanometry versus direct middle ear pressure measurement in an artificial model: is tympanometry an accurate method to measure middle ear pressure? Otol Neurotol 24(6):850–853CrossRefPubMed

18.

Flisberg K, Ingelstedt S, Ortegren U (1963) On middle ear pressure. Acta Otolaryngol Suppl 182:43–56. https://doi.org/10.3109/00016486309139992CrossRefPubMed

19.

Elner A, Ingelstedt S, Ivarsson A (1971) Indirect determination of the middle ear pressure. The normal middle ear pressure. A study of 86 cases. Acta Otolaryngol. 72(4):255–261. https://doi.org/10.3109/00016487109122480CrossRefPubMed

20.

Sonotubometry VH (1978) An acoustical method for objective measurement of auditory tubal opening. Acta Otolaryngol 86(1–2):93–103. https://doi.org/10.3109/00016487809124724CrossRef

21.

Okubo J, Watanabe I, Shibusawa M, Ishikawa N, Ishida H, Teramura K (1987) Sonotubometric measurement of the eustachian tube function by means of band noise. A clinical view of the acoustic measurement of the eustachian tube. ORL J Otorhinolaryngol Relat Spec. 49(5):242–252. https://doi.org/10.1159/000275944CrossRefPubMed

22.

van der Avoort SJ, van Heerbeek N, Zielhuis GA, Cremers CW (2005) Sonotubometry: eustachian tube ventilatory function test: a state-of-the-art review. Otol Neurotol. 26(3):538–543. https://doi.org/10.1097/01.mao.0000169765.00798.cd. (discussion 43)CrossRefPubMed

23.

Beleskiene V, Lesinskas E, Januskiene V, Daunoraviciene K, Rauba D, Ivaska J (2016) Eustachian tube opening measurement by sonotubometry using perfect sequences for healthy adults. Clin Exp Otorhinolaryngol 9(2):116–122. https://doi.org/10.21053/ceo.2015.00626CrossRefPubMedPubMedCentral

24.

Pyne JM, Amoako-Tuffour Y, Earle G, McIntyre G, Butler MB, Bance M (2017) Transmission of a novel sonotubometry acoustic click stimulus in healthy and patulous eustachian tube subjects: a retrospective case-control study. J Otolaryngol Head Neck Surg 46(1):47. https://doi.org/10.1186/s40463-017-0227-xCrossRefPubMedPubMedCentral

25.

Mondain M, Vidal D, Bouhanna S, Uziel A (1997) Monitoring eustachian tube opening: preliminary results in normal subjects. Laryngoscope 107(10):1414–1419. https://doi.org/10.1097/00005537-199710000-00022CrossRefPubMed

26.

van der Avoort SJ, van Heerbeek N, Admiraal RJ, Zielhuis GA, Cremers CW (2008) Results of sonotubometry in testing eustachian tube ventilatory function in children with cleft palate. Ann Otol Rhinol Laryngol 117(5):335–340. https://doi.org/10.1177/000348940811700502CrossRefPubMed

27.

Di Martino EF, Thaden R, Antweiler C, Reineke T, Westhofen M, Beckschebe J et al (2007) Evaluation of Eustachian tube function by sonotubometry: results and reliability of 8 kHz signals in normal subjects. Eur Arch Otorhinolaryngol 264(3):231–236. https://doi.org/10.1007/s00405-006-0172-1CrossRefPubMed

28.

Asenov DR, Nath V, Telle A, Antweiler C, Walther LE, Vary P et al (2010) Sonotubometry with perfect sequences: first results in pathological ears. Acta Otolaryngol 130(11):1242–1248. https://doi.org/10.3109/00016489.2010.492481CrossRefPubMed

29.

Ruan K, Li J, Tan S, Liu L, Tang A (2020) Comparison of sonotubometry, impedance, tubo-tympano-aerography, and tubomanometry to test eustachian tube function. Am J Otolaryngol. 41(2):102384. https://doi.org/10.1016/j.amjoto.2019.102384CrossRefPubMed

30.

Ars B (2003) Fibrocartilaginous eustachian tube middle ear cleft. Kugler Publications, The Hauge

31.

Alper CM, Teixeira MS, Kim JH, Douglas SJ (2017) Diagnostic accuracy of tubomanometry R value in detecting the Eustachian tube pressure equalizing function. Eur Arch Otorhinolaryngol 274(4):1865–1872. https://doi.org/10.1007/s00405-016-4430-6CrossRefPubMed

32.

Ros L, Gargula S, Montava M, Michel J, Radulesco T, Lavieille JP (2022) Place of tubomanometry in patulous eustachian tube diagnosis. Otolaryngol Head Neck Surg. https://doi.org/10.1177/01945998221108118CrossRef

33.

Schroder S, Lehmann M, Korbmacher D, Sauzet O, Sudhoff H, Ebmeyer J (2015) Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive eustachian tube dysfunction. Clin Otolaryngol 40(6):691–697. https://doi.org/10.1111/coa.12451CrossRefPubMed

34.

Smith ME, Zou CC, Baker C, Blythe AJC, Hutchinson PJA, Tysome JR (2017) The repeatability of tests of eustachian tube function in healthy ears. Laryngoscope 127(11):2619–2626. https://doi.org/10.1002/lary.26534CrossRefPubMed

35.

Zhang J, Zhong Z, Xiao S, Liu Y, Zhen Z, Ren L et al (2018) Tubomanometry value as an associated factor for medication outcomes in adult acute otitis media with effusion. Eur Arch Otorhinolaryngol 275(1):53–57. https://doi.org/10.1007/s00405-017-4772-8CrossRefPubMed

36.

Jenckel F, Kappo N, Gliese A, Loewenthal M, Lorincz BB, Knecht R et al (2015) Endonasal dilatation of the eustachian tube (EET) in children: feasibility and the role of tubomanometry (Estève) in outcomes measurement. Eur Arch Otorhinolaryngol 272(12):3677–3683. https://doi.org/10.1007/s00405-014-3443-2CrossRefPubMed

37.

Collin M, Coulange M, Deveze A, Montava M, Esteve D, Lavieille JP (2012) Middle ear barotraumas due to rhinopharyngeal scar tissue: tubomanometry diagnostic and therapeutic contribution. Rev Laryngol Otol Rhinol (Bord) 133(3):157–161PubMed

38.

Smith ME, Cochrane IL, Donnelly N, Axon PR, Tysome JR (2018) The performance of patient-reported outcome measures as diagnostic tools for eustachian tube dysfunction. Otol Neurotol 39(9):1129–1138. https://doi.org/10.1097/MAO.0000000000001931CrossRefPubMed

39.

McCoul ED, Anand VK, Christos PJ (2012) Validating the clinical assessment of eustachian tube dysfunction: the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope 122(5):1137–1141. https://doi.org/10.1002/lary.23223CrossRefPubMedPubMedCentral

40.

Van Roeyen S, Van de Heyning P, Van Rompaey V (2015) Value and discriminative power of the seven-item Eustachian Tube Dysfunction Questionnaire. Laryngoscope 125(11):2553–2556. https://doi.org/10.1002/lary.25316CrossRefPubMed

41.

Ikeda R, Kikuchi T, Miyazaki H, Hidaka H, Kawase T, Katori Y et al (2018) The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous eustachian tube patient. Acta Otolaryngol 138(1):6–9. https://doi.org/10.1080/00016489.2017.1366053CrossRefPubMed

42.

Teixeira MS, Swarts JD, Alper CM (2018) Accuracy of the ETDQ-7 for identifying persons with eustachian tube dysfunction. Otolaryngol Head Neck Surg 158(1):83–89. https://doi.org/10.1177/0194599817731729CrossRefPubMed

43.

Schroder S, Lehmann M, Sauzet O, Ebmeyer J, Sudhoff H (2015) A novel diagnostic tool for chronic obstructive eustachian tube dysfunction-the eustachian tube score. Laryngoscope 125(3):703–708. https://doi.org/10.1002/lary.24922CrossRefPubMed

44.

Alper CM, Teixeira MS, Swarts JD (2016) Correlations between videoendoscopy and sonotubometry of eustachian tube opening during a swallow. Laryngoscope 126(12):2778–2784. https://doi.org/10.1002/lary.25928CrossRefPubMedPubMedCentral

45.

Kumazawa T, Honda K, Iwano T, Kinoshita T (1990) New findings in observations by tubo-tympano-aerodynamic method. Acta Otolaryngol Suppl 471:25–32. https://doi.org/10.3109/00016489009124805CrossRefPubMed

46.

Meyer MF, Korthauer C, Jansen S, Huttenbrink KB, Beutner D (2018) Analyzing eustachian tube function in patients with symptoms of chronical eustachian tube dysfunction by pressure chamber measurements. Eur Arch Otorhinolaryngol 275(5):1087–1094. https://doi.org/10.1007/s00405-018-4938-zCrossRefPubMed

47.

Bluestone CD, Cantekin EI (1981) Current clinical methods, indications and interpretation of eustachian tube function tests. Ann Otol Rhinol Laryngol 90(6 Pt 1):552–562. https://doi.org/10.1177/000348948109000608CrossRefPubMed

48.

Tucci DL, McCoul ED, Rosenfeld RM, Tunkel DE, Batra PS, Chandrasekhar SS et al (2019) Clinical consensus statement: balloon dilation of the eustachian tube. Otolaryngol Head Neck Surg 161(1):6–17. https://doi.org/10.1177/0194599819848423CrossRefPubMed

49.

Smith ME, Scoffings DJ, Tysome JR (2016) Imaging of the Eustachian tube and its function: a systematic review. Neuroradiology 58(6):543–556. https://doi.org/10.1007/s00234-016-1663-4CrossRefPubMedPubMedCentral

50.

Tarabichi M, Najmi M (2015) Visualization of the eustachian tube lumen with valsalva computed tomography. Laryngoscope 125(3):724–729. https://doi.org/10.1002/lary.24979CrossRefPubMed

51.

Jufas N, Deveau N, Bance M (2016) Dynamic cine imaging of the eustachian tube using four-dimensional computed tomography. J Laryngol Otol 130(12):1162–1164. https://doi.org/10.1017/S0022215116009257CrossRefPubMed

52.

Lee S, Oh SJ, Choi SW, Hwangbo L, Lee HM, Lee IW et al (2020) The usefulness of valsalva computed tomography as an assessment tool for the eustachian tube. Am J Otolaryngol. 41(4):102499. https://doi.org/10.1016/j.amjoto.2020.102499CrossRefPubMed

53.

Alper CM, Rath TJ, Teixeira MS, Swarts JD (2018) A novel imaging method for the cartilaginous eustachian tube lumen: computerized tomography during the forced response test. Ann Otol Rhinol Laryngol 127(1):13–20. https://doi.org/10.1177/0003489417740363CrossRefPubMed

54.

Tarabichi M, Kapadia M (2016) Preoperative and intraoperative evaluation of the eustachian tube in chronic ear surgery. Otolaryngol Clin N Am 49(5):1135–1147. https://doi.org/10.1016/j.otc.2016.05.004CrossRef

55.

Linstrom CJ, Silverman CA, Rosen A, Meiteles LZ (2000) Eustachian tube endoscopy in patients with chronic ear disease. Laryngoscope 110(11):1884–1889. https://doi.org/10.1097/00005537-200011000-00022CrossRefPubMed

56.

Hamrang-Yousefi S, Ng J, Andaloro C. Eustachian Tube Dysfunction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. https://www.ncbi.nlm.nih.gov/books/NBK555908/. Accessed 13 Feb 2023

57.

Robison JG, Wilson C, Otteson TD, Chakravorty SS, Mehta DK (2012) Increased eustachian tube dysfunction in infants with obstructive sleep apnea. Laryngoscope 122(5):1170–1177. https://doi.org/10.1002/lary.22473CrossRefPubMed

58.

Alles R, Parikh A, Hawk L, Darby Y, Romero JN, Scadding G (2001) The prevalence of atopic disorders in children with chronic otitis media with effusion. Pediatr Allergy Immunol 12(2):102–106. https://doi.org/10.1046/j.0905-6157.2000.00008.xCrossRefPubMed

59.

Heikkinen T, Chonmaitree T (2003) Importance of respiratory viruses in acute otitis media. Clin Microbiol Rev 16(2):230–241. https://doi.org/10.1128/CMR.16.2.230-241.2003CrossRefPubMedPubMedCentral

60.

Doyle WJ, Cantekin EI, Bluestone CD (1980) Eustachian tube function in cleft palate children. Ann Otol Rhinol Laryngol Suppl 89(3 Pt 2):34–40. https://doi.org/10.1177/00034894800890s311CrossRefPubMed

61.

Ramia M, Musharrafieh U, Khaddage W, Sabri A (2014) Revisiting Down syndrome from the ENT perspective: review of literature and recommendations. Eur Arch Otorhinolaryngol 271(5):863–869. https://doi.org/10.1007/s00405-013-2563-4CrossRefPubMed

62.

Sudhoff HH, Mueller S (2018) Treatment of pharyngotympanic tube dysfunction. Auris Nasus Larynx 45(2):207–214. https://doi.org/10.1016/j.anl.2017.07.001CrossRefPubMed

Titel: Assessment of the Eustachian tube: a review
verfasst von: Shanshan Liu
Xin Ni
Jie Zhang
Publikationsdatum: 29.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 9/2023
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08026-5

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Assessment of the Eustachian tube: a review

Abstract

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Conclusion

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