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Analyzing eustachian tube function in patients with symptoms of chronical Eustachian tube dysfunction by pressure chamber measurements

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The determination of Eustachian tube dysfunction (ETD) subtypes in daily routines is based on symptoms of the patient, otoscopy, nasopharyngoscopy, tympanometry, pure tone audiometry, and Valsalva’s test, even though this clinical assessment is often not sufficient to clearly diagnose the subtype. In the study, we have evaluated the possibility of the determination of different subtypes of ETD by pressure chamber measurements.

Methods

In a single-person pressure chamber, we exposed 17 patients to pressure increases and decreases. The pressure profile of the continuous impedance of each tympanic membrane during the 5-min lasting measurement and the Eustachian tube (ET) pressure equilibration function reflecting parameters—ET opening pressure (ETOP), ET opening duration (ETOD), ET closing pressure (ETCP), and ET opening frequency (ETOF)—were documented and analyzed.

Results

By interpretation of the pattern of the continuous impedance of the tympanic membrane, we could relate patients to a subtype of ETD. Clearly identified by pressure chamber-based measurements could be patients with patulous ETD (n = 2) and baro-challenged-induced ETD (n = 4). The remaining 11 patients were classified as ETD not further classified. Patients diagnosed as patulous ETD did not show a pressure response on the tympanic membrane during the phases of pressure increase and decrease. In patients with baro-challenged-induced ETD, the measurement had to be interrupted due to the development of otalgia during progressive pressure increase as a result of insufficient possibility to equalize pressure variations.

Conclusions

Pressure chamber-based measurements enable an objective and safe dynamic testing of the ET pressure equalization function in patients with ETD. In addition, via continuous impedance measurement, it is possible to identify patients with patulous ETD and baro-challenge-induced ETD. These results are a relevant preliminary work to identify and assess patients for different therapy options.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Moritz F. Meyer, Christine Korthäuer, Stefanie Jansen, Karl-Bernd Hüttenbrink & Dirk Beutner

  2. Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany

    Dirk Beutner

Authors
  1. Moritz F. Meyer
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  2. Christine Korthäuer
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  3. Stefanie Jansen
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  4. Karl-Bernd Hüttenbrink
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  5. Dirk Beutner
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Corresponding author

Correspondence to Moritz F. Meyer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Meyer, M.F., Korthäuer, C., Jansen, S. et al. Analyzing eustachian tube function in patients with symptoms of chronical Eustachian tube dysfunction by pressure chamber measurements. Eur Arch Otorhinolaryngol 275, 1087–1094 (2018). https://doi.org/10.1007/s00405-018-4938-z

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  • DOI: https://doi.org/10.1007/s00405-018-4938-z

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