Tuboimpedance: A New Test of Eustachian Tube Function
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Publication Date
2017-04Journal Title
Otolaryngology-Head and Neck Surgery
ISSN
0194-5998
Publisher
SAGE Publications
Volume
156
Pages
717-721
Language
English
Type
Article
This Version
AM
Metadata
Show full item recordCitation
Smith, M., Zou, C. C., Blythe, A. J., & Tysome, J. R. (2017). Tuboimpedance: A New Test of Eustachian Tube Function. Otolaryngology-Head and Neck Surgery, 156 717-721. https://doi.org/10.1177/0194599816686546
Abstract
$\textbf{Objective}$
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.
$\textbf{Study Design}$
Exploratory cohort diagnosis study.
$\textbf{Setting}$
Tertiary referral center.
$\textbf{Subjects}$
Twenty screened, healthy ears (10 volunteers).
$\textbf{Methods}$
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.
$\textbf{Results}$
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.
$\textbf{Conclusion}$
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.
Sponsorship
Sponsorships: Cambridge University Hospitals NHS Foundation Trust.
Funding source: Cambridge Hearing Trust and Spiggle and Theis GmbH.
Identifiers
External DOI: https://doi.org/10.1177/0194599816686546
This record's URL: https://www.repository.cam.ac.uk/handle/1810/262864
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